Contract Details
Facility name
Advanced Health Services Inc
Provider ID
P000005621
NPI
1922050434
Tax ID
200419015
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
10646 West 165th St
Orland Park, IL 60467
United States
County
Cook
Phone
7083640261 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address