1033383526 NPI number — ADMINISTER MEDICAL ASSOCIATES LTD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033383526 NPI number — ADMINISTER MEDICAL ASSOCIATES LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADMINISTER MEDICAL ASSOCIATES LTD
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:
1033383526
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/16/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3330 WEST 177TH STREET SUITE 3G
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAZEL CREST
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60429
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3330 WEST 177TH STREET SUITE 3G
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAZEL CREST
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60429
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
708-798-1200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/16/2008

Additional Information

Authorized Official

Authorized Official Last Name:
SOWADE
Authorized Official First Name:
OLALEKAN
Authorized Official Middle Name:
Authorized Official Title or Position:
MD
Authorized Official Telephone Number:
312-375-6950

Provider Taxonomy Codes

  • Taxonomy code: 261QP2300X , with the licence number:  036095861 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com