Provider Demographics
NPI:1063960276
Name:MARS HEALTHCARE LLC
Entity type:Organization
Organization Name:MARS HEALTHCARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMJAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SAFVI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-650-0580
Mailing Address - Street 1:1440 S VILLA AVE
Mailing Address - Street 2:
Mailing Address - City:VILLA PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60181-3405
Mailing Address - Country:US
Mailing Address - Phone:630-650-0580
Mailing Address - Fax:
Practice Address - Street 1:721 W HIGHWAY 22ND
Practice Address - Street 2:
Practice Address - City:LAKE ZURICH
Practice Address - State:IL
Practice Address - Zip Code:60047
Practice Address - Country:US
Practice Address - Phone:630-650-0580
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-16
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology