Healthcare Provider Details

I. General information

NPI: 1811097918
Provider Name (Legal Business Name): HIGH-TECH IMAGING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 03/09/2021
Certification Date: 03/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 SHAWMUT AVE STE 209
LA GRANGE IL
60526-2000
US

IV. Provider business mailing address

405 SHAWMUT AVE STE 209
LA GRANGE IL
60526-2000
US

V. Phone/Fax

Practice location:
  • Phone: 708-442-9292
  • Fax: 708-442-0808
Mailing address:
  • Phone: 708-442-9292
  • Fax: 708-442-0808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246XS1301X
TaxonomySonography Specialist/Technologist Cardiovascular
License Number
License Number State

VIII. Authorized Official

Name: MRS. STARLA HUGHES
Title or Position: PRESIDENT
Credential: RDMS, RDCS, RVT, RT
Phone: 708-442-9292