Provider Demographics
NPI:1699915348
Name:ILLINOIS EMERGENCY STAFFING SOLUTIONS, INC.
Entity type:Organization
Organization Name:ILLINOIS EMERGENCY STAFFING SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-934-3200
Mailing Address - Street 1:17304 PRESTON RD
Mailing Address - Street 2:SUITE 555
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-5618
Mailing Address - Country:US
Mailing Address - Phone:972-934-3200
Mailing Address - Fax:
Practice Address - Street 1:200 S CEDAR ST
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62565-1838
Practice Address - Country:US
Practice Address - Phone:217-774-3961
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-20
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Multi-Specialty