Healthcare Provider Details

I. General information

NPI: 1164891727
Provider Name (Legal Business Name): SONIC IMAGING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2015
Last Update Date: 01/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4N277 9TH AVE
ADDISON IL
60101
US

IV. Provider business mailing address

4N277 9TH AVE
ADDISON IL
60101-2178
US

V. Phone/Fax

Practice location:
  • Phone: 630-433-2343
  • Fax: 877-770-2124
Mailing address:
  • Phone: 630-433-2343
  • Fax: 877-770-2124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. HENRY BISKUP
Title or Position: CEO
Credential: RDMS
Phone: 630-441-4883