Healthcare Provider Details
I. General information
NPI: 1144387176
Provider Name (Legal Business Name): HINSDALE ORTHOPAEDIC IMAGING CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2940 ROLLING RIDGE RD SUITE 102
NAPERVILLE IL
60564-4231
US
IV. Provider business mailing address
550 W OGDEN AVE
HINSDALE IL
60521-3186
US
V. Phone/Fax
- Phone: 630-579-6500
- Fax: 630-579-5860
- Phone: 630-323-6116
- Fax: 630-323-6169
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM1200X |
| Taxonomy | Magnetic Resonance Imaging (MRI) Clinic/Center |
| License Number | |
| License Number State | IL |
VIII. Authorized Official
Name: DR.
KENNETH
L
SCHIFFMAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 630-323-6116