Healthcare Provider Details
I. General information
NPI: 1235468059
Provider Name (Legal Business Name): PDQ IMAGING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/08/2009
Last Update Date: 11/08/2022
Certification Date: 11/08/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2500 FARM ROAD 79 STE 2
PARIS TX
75460-4427
US
IV. Provider business mailing address
8235 CHRISTIANA AVE
SKOKIE IL
60076-2910
US
V. Phone/Fax
- Phone: 800-879-2343
- Fax: 877-879-7379
- Phone: 224-337-1000
- Fax: 224-337-0100
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 335V00000X |
| Taxonomy | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ETAI
SOOLIMAN
Title or Position: CEO
Credential:
Phone: 224-337-1000