# DIVERSIFIED MEDICAL SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780962506
- **Authorized official:** SHAKEEL AHMED MD (PRESIDENT)
- **Authorized official phone:** (618) 239-0678

## Contact information

- **Practice address:** 5023 N ILLINOIS ST, STE 1, FAIRVIEW HEIGHTS, IL 62208-3453
- **Practice address phone:** (618) 239-0678
- **Practice address fax:** (800) 516-2392
- **Mailing address:** 5023 N ILLINOIS ST, STE 1, FAIRVIEW HEIGHTS, IL 62208-3453
- **Mailing address phone:** (618) 239-0678
- **Mailing address fax:** (800) 516-2392

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/27/2011
- **Last updated:** 09/12/2011