Provider Demographics
NPI:1972340867
Name:MIDWEST EXPRESS CARE 2 INC
Entity type:Organization
Organization Name:MIDWEST EXPRESS CARE 2 INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CC SPECIALIST LEAD
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BATY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-789-6574
Mailing Address - Street 1:PO BOX 775253
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-5253
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4323 S PULASKI RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60632-4008
Practice Address - Country:US
Practice Address - Phone:773-389-3591
Practice Address - Fax:773-453-8564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies