Organization
NEURODIAGNOSTIC SERVICES LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY STEPHENS MD (OWNER)
(708) 388-4902
Entity
Organization
Contact information
Practice address
2310 YORK ST, #2C, BLUE ISLAND, IL 60406-2411
(708) 388-4902
(708) 388-0043
Mailing address
777 OAKMONT LN, SUITE 1600, WESTMONT, IL 60559-5511
(630) 789-2550
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
031603006
BCBS PROVIDER ID
IL
01
—
131781400
ACS HEALTHNET
IL
01
—
CL0157
RAIL ROAD MEDICARE
IL
Enumeration date
08/11/2006
Last updated
07/01/2008
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