Organization
MIDWEST MEDICAL SERVICES INC
Active
Other names
Advance Ambulance
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN WITEK (PRESIDENT)
(773) 774-8875
Entity
Organization
Contact information
Practice address
5567 N ELSTON AVE, CHICAGO, IL 60630-1314
(773) 774-8999
(630) 510-4501
Mailing address
PO BOX 5988, DEPT 20-5056, CAROL STREAM, IL 60197-5988
(773) 774-8999
(630) 510-4501
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
10 8963
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01629912
BCBS
IL
01
—
132743900
DEPT OF LABOR OWCP
IL
01
—
590014475
RR MEDICARE
IL
Enumeration date
05/26/2006
Last updated
10/02/2013
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