Healthcare Provider Details

I. General information

NPI: 1467402347
Provider Name (Legal Business Name): AFFILIATED RADIOLOGISTS, SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 08/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 W HARRISON ST SUITE 437
CHICAGO IL
60612-3841
US

IV. Provider business mailing address

1725 W HARRISON ST SUITE 437
CHICAGO IL
60612-3841
US

V. Phone/Fax

Practice location:
  • Phone: 312-563-4270
  • Fax: 312-563-4280
Mailing address:
  • Phone: 312-563-4270
  • Fax: 312-563-4280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER ARCHER
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 312-563-4275