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General NPI Number Information
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NPI Number | 1134686439
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Entity Type | Organization
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Legal Business Name | QUALSIGHT LLC
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Dates
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Enumeration Date | 02/23/2019
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Last Update Date | 02/23/2019
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Provider Practice Location Address
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Address Line | 9525 BRYN MAWR AVE STE 725
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City | ROSEMONT
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State | IL
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Zip | 60018-5262
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Country | US
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Telephone | 773-350-3357
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Fax | 773-632-4132
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Provider Business Mailing Address
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Address Line | 9525 BRYN MAWR AVE STE 725
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City | ROSEMONT
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State | IL
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Zip | 60018-5262
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Country | US
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Telephone | 773-350-3357
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Fax | 773-632-4132
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Authorized Official
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Title or Position | PRESIDENT
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Name | LINCK BASCOMB
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Credential | MANAGEMENT
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Telephone | 773-350-3357
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number |
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License Number State |
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