MEDICARE: DIAGNOSTIC SOLUTIONS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0208X	Mobile Radiology Clinic/Center

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00212568	OTHER	IL	RETIRED RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2232473	OTHER	IL	IL BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1518918747
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIAGNOSTIC SOLUTIONS, INC.

Provider Business Mailing Address
First Line	:	1730 AVALON CT
Second Line	:
City	:	GLENDALE HEIGHTS
State	:	IL
Zip	:	60139-1895
Country	:	US
Telephone Number	:	630-462-9317
Fax Number	:	630-462-0529

Provider Business Practice Location Address
First Line	:	1730 AVALON CT
Second Line	:
City	:	GLENDALE HEIGHTS
State	:	IL
Zip	:	60139-1895
Country	:	US
Telephone Number	:	630-462-9317
Fax Number	:	630-462-0529

Authorized Official
Title or Position	:	SECRETARY
Name	:	EUGENIA WOLF
Credential	:	RDMS, RDCS, RVT
Telephone Number	:	630-462-9317

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	12/28/2011

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Directions to “DIAGNOSTIC SOLUTIONS, INC. ” Practice Location

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