# INNOVATIVE PHYSICIAN SERVICES LLC

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

## Provider details

- **NPI number:** 1922096049
- **Authorized official:** DR. ADNAN M DAHDUL M.D. (OWNER/CEO/OFFICER)
- **Authorized official phone:** (413) 301-6019

## Contact information

- **Practice address:** 490 PAGE BOULEVARD, SPRINGFIELD, MA 01104
- **Practice address phone:** (413) 349-5063
- **Practice address fax:** (413) 363-2857
- **Mailing address:** 95 FRANK B MURRAY ST, SPRINGFIELD, MA 01103-1106
- **Mailing address phone:** (413) 301-6019
- **Mailing address fax:** (413) 363-2857

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 111N00000X | Chiropractor | — | NULL | — |
| 111N00000X | Chiropractor | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 10/12/2005
- **Last updated:** 08/06/2025