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General NPI Number Information
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NPI Number | 1295846343
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Entity Type | Organization
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Legal Business Name | JOLIET RADIOLOGICAL SERVICE CORP
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 10/29/2019
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Provider Practice Location Address
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Address Line | 333 N MADISON ST
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City | JOLIET
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State | IL
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Zip | 60435
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Country | US
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Telephone | 815-741-7215
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Fax | 815-741-7591
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Provider Business Mailing Address
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Address Line | 333 N MADISON ST
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City | JOLIET
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State | IL
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Zip | 60435
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Country | US
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Telephone | 815-741-7215
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Fax | 815-741-7591
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Authorized Official
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Title or Position | MD PRES OF CORP
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Name | DR. MICHAEL ARTHOFER
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Credential | MD
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Telephone | 815-741-7215
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 042000027
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License Number State | IL
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