Provider Demographics
NPI:1215982491
Name:MIDWEST URGENT MEDICAL SERVICES LLC
Entity type:Organization
Organization Name:MIDWEST URGENT MEDICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/PHYSICIAN MD/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ARIF
Authorized Official - Middle Name:G
Authorized Official - Last Name:JAKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:414-431-6900
Mailing Address - Street 1:4555 W SCHROEDER DR
Mailing Address - Street 2:SUITE 170
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53223-1475
Mailing Address - Country:US
Mailing Address - Phone:414-365-3210
Mailing Address - Fax:414-365-3225
Practice Address - Street 1:2603 W RAWSON AVE
Practice Address - Street 2:SUITE 113
Practice Address - City:OAK CREEK
Practice Address - State:WI
Practice Address - Zip Code:53154-8422
Practice Address - Country:US
Practice Address - Phone:414-431-6900
Practice Address - Fax:414-435-0016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI21263900Medicaid
WI21263900Medicaid