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General NPI Number Information
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NPI Number | 1295077188
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Entity Type | Organization
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Legal Business Name | SPEED IMAGING LLC
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Dates
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Enumeration Date | 03/19/2013
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Last Update Date | 04/05/2022
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Provider Practice Location Address
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Address Line | 1263 S HIGHLAND AVE STE 2D
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City | LOMBARD
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State | IL
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Zip | 60148-4527
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Country | US
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Telephone | 630-814-9911
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Fax |
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Provider Business Mailing Address
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Address Line | 1263 S HIGHLAND AVE STE 2D
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City | LOMBARD
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State | IL
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Zip | 60148-4527
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Country | US
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Telephone | 630-814-9911
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Fax |
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Authorized Official
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Title or Position | MR
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Name | MOHAMMED A ASHFAQ
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Credential |
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Telephone | 630-656-1455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471N0900X
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Taxonomy Name | Nuclear Medicine Technology Radiologic Technologist
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License Number | 034872
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2471S1302X
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Taxonomy Name | Sonography Radiologic Technologist
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License Number | 111990
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 246XS1301X
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Taxonomy Name | Sonography Specialist/Technologist Cardiovascular
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License Number | 111990
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License Number State | IL
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