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Organization
MEDICAL SERVICE AND SUPPORT LLC MBFS
Active
Organization
MEDICAL SERVICE AND SUPPORT LLC MBFS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENGARAJU GANESAN MBA (MD)
(773) 746-6050
Entity
Organization
Contact information
Practice address
500 LINDEN AVENUE, OAK PARK, IL 60302-1659
(773) 746-6050
Mailing address
500 LINDEN AVE, OAK PARK, IL 60302-1659
(773) 746-6050
Taxonomy
Speciality
Code
Description
License number
State
251X00000X
Supports Brokerage Agency
Primary
01883194
IL
Other
Enumeration date
12/19/2006
Last updated
08/22/2020
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