Healthcare Provider Details

I. General information

NPI: 1083637417
Provider Name (Legal Business Name): HIAS DIAGNOSTICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4160 IL ROUTE 83 STE 204-B
LONG GROVE IL
60047-8034
US

IV. Provider business mailing address

4160 IL ROUTE 83 STE 204-B
LONG GROVE IL
60047-8034
US

V. Phone/Fax

Practice location:
  • Phone: 312-972-7777
  • Fax: 847-972-1867
Mailing address:
  • Phone: 312-972-7777
  • Fax: 847-972-1867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number036063273
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL SCHOKIN
Title or Position: OFFICE MANAGER
Credential:
Phone: 312-972-7777