Healthcare Provider Details

I. General information

NPI: 1811285018
Provider Name (Legal Business Name): NATIONAL DIAGNOSTIC SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2011
Last Update Date: 07/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 E ROOSEVELT RD SUITE# 2G
LOMBARD IL
60148-4640
US

IV. Provider business mailing address

330 E ROOSEVELT RD SUITE# 2G
LOMBARD IL
60148-4640
US

V. Phone/Fax

Practice location:
  • Phone: 630-673-0756
  • Fax:
Mailing address:
  • Phone: 630-673-0756
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. MUHAMMAD ARIF RAISANI
Title or Position: PRESIDENT
Credential:
Phone: 630-673-0756