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General NPI Number Information
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NPI Number | 1013429125
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Entity Type | Organization
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Legal Business Name | DIAGNOSTIC SERVICES LLC
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Dates
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Enumeration Date | 10/30/2017
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Last Update Date | 04/05/2018
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Provider Practice Location Address
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Address Line | 16101 WEBER RD UNIT A
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City | CREST HILL
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State | IL
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Zip | 60403-8813
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Country | US
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Telephone | 630-277-3902
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Fax | 815-327-3737
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Provider Business Mailing Address
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Address Line | 12717 WILD RYE CT
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City | PLAINFIELD
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State | IL
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Zip | 60585-2977
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ZACHARY A VAZQUEZ
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Credential |
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Telephone | 630-277-3902
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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