Healthcare Provider Details

I. General information

NPI: 1922159482
Provider Name (Legal Business Name): PIONEER DIAGNOSTICS AND RESEARCH CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 02/23/2024
Certification Date: 02/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

387 SHUMAN BLVD STE 210E
NAPERVILLE IL
60563-8146
US

IV. Provider business mailing address

7530 WOODWARD AVE STE D
WOODRIDGE IL
60517-3100
US

V. Phone/Fax

Practice location:
  • Phone: 630-329-8166
  • Fax:
Mailing address:
  • Phone: 877-470-7531
  • Fax: 888-706-4887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number
License Number State

VIII. Authorized Official

Name: SAMEENA ISRAR
Title or Position: OWNER
Credential:
Phone: 630-329-8161