Healthcare Provider Details

I. General information

NPI: 1750300935
Provider Name (Legal Business Name): ASCOT DIAGNOSTIC SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 01/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 - B WEST HIGGINS RD
HOFFMAN ESTATES IL
60169
US

IV. Provider business mailing address

138 - B WEST HIGGINS RD
HOFFMAN ESTATES IL
60169
US

V. Phone/Fax

Practice location:
  • Phone: 847-884-7090
  • Fax: 847-884-7133
Mailing address:
  • Phone: 847-884-7090
  • Fax: 847-884-7133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: AKBER KHAN
Title or Position: PRESIDENT / OWNER
Credential:
Phone: 847-884-7090