| Ml Medical Services Corporation | |
|
5535 W Cermak Rd Suite B Cicero IL 60804-2218 | |
| (708) 652-5423 | |
| (708) 652-5424 |
| Full Name | Ml Medical Services Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 5535 W Cermak Rd, Cicero, Illinois |
| Authorized Official Name and Position | Israel Labao (CEO) |
| Authorized Official Contact | 7086525423 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ml Medical Services Corporation 5535 W Cermak Rd Suite B Cicero IL 60804-2218 Ph: (708) 652-5423 | Ml Medical Services Corporation 5535 W Cermak Rd Suite B Cicero IL 60804-2218 Ph: (708) 652-5423 |
| NPI Number | 1922280296 |
|---|---|
| Provider Enumeration Date | 11/28/2007 |
| Last Update Date | 10/05/2012 |
| Medicare PECOS PAC ID | 2769416395 |
|---|---|
| Medicare Enrollment ID | O20050923000045 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922280296 | NPI | - | NPPES |
| 1635391 | Other | IL | BLUE CROSS BLUE SHIELD |
| 036077467 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 336040596 (36077467) (Illinois) | Primary |
| Provider Name | Israel D Labao |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1487655726 PECOS PAC ID: 1557330594 Enrollment ID: I20040928000079 |
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