Healthcare Provider Details

I. General information

NPI: 1134520950
Provider Name (Legal Business Name): HIGHPOINT MEDICAL IMAGING OF CHICAGO RIDGE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2014
Last Update Date: 09/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9830 RIDGELAND AVE SUITE 4
CHICAGO RIDGE IL
60415-2667
US

IV. Provider business mailing address

9830 RIDGELAND AVE SUITE 4
CHICAGO RIDGE IL
60415-2667
US

V. Phone/Fax

Practice location:
  • Phone: 708-423-1819
  • Fax:
Mailing address:
  • Phone: 708-423-1819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. ALECIA GIUNTA
Title or Position: EXECUTIVE VICE PRESIDENT
Credential:
Phone: 708-423-1819