Healthcare Provider Details

I. General information

NPI: 1295652451
Provider Name (Legal Business Name): MEDICAL IMAGING SPECIALIST IN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2075 CLARK RD
GARY IN
46404-2576
US

IV. Provider business mailing address

2075 CLARK RD
GARY IN
46404-2576
US

V. Phone/Fax

Practice location:
  • Phone: 708-634-2929
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number
License Number State

VIII. Authorized Official

Name: AHMAD HUSSEIN
Title or Position: PRESIDENT
Credential:
Phone: 708-634-2929