Healthcare Provider Details
I. General information
NPI: 1689613804
Provider Name (Legal Business Name): METROPOLITAN ADVANCED RADIOLOGICAL SERVICES, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/05/2006
Last Update Date: 01/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3249 OAK PARK AVE
BERWYN IL
60402-3429
US
IV. Provider business mailing address
3249 SOUTH OAK PARK AVE.
BERWYN IL
60402
US
V. Phone/Fax
- Phone: 708-783-2696
- Fax: 708-783-3164
- Phone: 708-783-2696
- Fax: 708-783-3164
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085B0100X |
| Taxonomy | Body Imaging Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085N0700X |
| Taxonomy | Neuroradiology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085N0904X |
| Taxonomy | Nuclear Radiology Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085U0001X |
| Taxonomy | Diagnostic Ultrasound Physician |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARK
W
ARNETT
Title or Position: PRESIDENT
Credential: M.D.
Phone: 708-783-3532