1952488066 NPI number — A2CL SERVICES, LLC

Table of content: (NPI 1952488066)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952488066 NPI number — A2CL SERVICES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A2CL SERVICES, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952488066
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/13/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8901 W LINCOLN AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST ALLIS
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53227-2409
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
414-328-7580
Provider Business Mailing Address Fax Number:
414-328-7587

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5400 PEARL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROSEMONT
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60018-5320
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-349-7000
Provider Business Practice Location Address Fax Number:
847-349-7380
Provider Enumeration Date:
11/01/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MUMM
Authorized Official First Name:
DAN
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
414-389-2657

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1710064811 . This is a "NPI" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".