Organization
ML MEDICAL SERVICES CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ISRAEL LABAO M.D. (CEO)
(708) 652-5423
Entity
Organization
Contact information
Practice address
5535 W CERMAK RD, SUITE B, CICERO, IL 60804-2218
(708) 652-5423
(708) 652-5424
Mailing address
5535 W CERMAK RD, SUITE B, CICERO, IL 60804-2218
(708) 652-5423
(708) 652-5424
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
336040596 (36077467)
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036077467
—
IL
01
—
1635391
BLUE CROSS BLUE SHIELD
IL
Enumeration date
11/28/2007
Last updated
10/05/2012
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