MEDICARE: ECUAMACHINES 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	132956	IL

General Provider Information

NPI Number	:	1770976979
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ECUAMACHINES INC.

Provider Business Mailing Address
First Line	:	3149 S KARLOV AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60623-4818
Country	:	US
Telephone Number	:	773-968-6549
Fax Number	:

Provider Business Practice Location Address
First Line	:	3149 S KARLOV AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60623-4818
Country	:	US
Telephone Number	:	773-968-6549
Fax Number	:

Authorized Official
Title or Position	:	SONOGRAPHER
Name	:	MR. CARLOS M. EGAS
Credential	:	REGISTERED US TECH
Telephone Number	:	773-971-6481

Provider Enumeration Date	:	03/11/2015
Last Update Date	:	03/11/2015

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