Healthcare Provider Details

I. General information

NPI: 1174839575
Provider Name (Legal Business Name): DAWN DIAGNOSTICS IMAGING GROUP INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2010
Last Update Date: 12/16/2021
Certification Date: 12/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8023 KILPATRICK AVE APT 1A
SKOKIE IL
60076-3055
US

IV. Provider business mailing address

8023 KILPATRICK AVE APT 1A
SKOKIE IL
60076-3055
US

V. Phone/Fax

Practice location:
  • Phone: 847-840-6761
  • Fax: 844-364-6372
Mailing address:
  • Phone: 847-840-6761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: IMTIAZ H AWAN
Title or Position: PRESIDENT
Credential:
Phone: 847-840-6761