Healthcare Provider Details

I. General information

NPI: 1740590694
Provider Name (Legal Business Name): CUREWELL DIAGNOSTIC SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2010
Last Update Date: 06/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 2ND AVE
ROCK FALLS IL
61071-1275
US

IV. Provider business mailing address

5795 N ELSTON AVE
CHICAGO IL
60646-5545
US

V. Phone/Fax

Practice location:
  • Phone: 815-622-0900
  • Fax: 773-631-5901
Mailing address:
  • Phone: 773-631-5900
  • Fax: 773-631-5901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. ZAFER ALI KHAN
Title or Position: DIRECTOR
Credential:
Phone: 224-636-3637