| Desired Medical Services Incorporated | |
|
3224 Ridge Rd Ste 201 Lansing IL 60438-3191 | |
| (708) 394-3296 | |
| Not Available |
| Full Name | Desired Medical Services Incorporated |
|---|---|
| Speciality | Clinic/Center |
| Location | 3224 Ridge Rd Ste 201, Lansing, Illinois |
| Authorized Official Name and Position | Lanneka White (OWNER) |
| Authorized Official Contact | 7083943296 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Desired Medical Services Incorporated 3224 Ridge Rd Ste 201 Lansing IL 60438-3191 Ph: (708) 394-3296 | Desired Medical Services Incorporated 3224 Ridge Rd Ste 201 Lansing IL 60438-3191 Ph: (708) 394-3296 |
| NPI Number | 1821607425 |
|---|---|
| Provider Enumeration Date | 07/29/2020 |
| Last Update Date | 12/07/2021 |
| Medicare PECOS PAC ID | 1951720580 |
|---|---|
| Medicare Enrollment ID | O20201001001370 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821607425 | NPI | - | NPPES |
| 277.000158 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Lanneka White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548662141 PECOS PAC ID: 0244551521 Enrollment ID: I20150611002746 |
| Provider Name | Gregory Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306620737 PECOS PAC ID: 9830338227 Enrollment ID: I20231127000095 |
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