Healthcare Provider Details
I. General information
NPI: 1952343246
Provider Name (Legal Business Name): MOBILE IMAGING SERVICES,INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2900 W PETERSON AVE SUITE 11
CHICAGO IL
60659-3818
US
IV. Provider business mailing address
2900 W PETERSON AVE SUITE 11
CHICAGO IL
60659-3818
US
V. Phone/Fax
- Phone: 773-544-1249
- Fax:
- Phone: 773-544-1249
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 335V00000X |
| Taxonomy | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MUNEER
S
HASAN
Title or Position: PRESIDENT
Credential:
Phone: 773-544-1249