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General NPI Number Information
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NPI Number | 1477841146
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Entity Type | Organization
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Legal Business Name | UNITED DIAGNOSTIC SERVICES, LLC
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Dates
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Enumeration Date | 07/15/2011
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Last Update Date | 01/26/2024
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Provider Practice Location Address
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Address Line | 110 S CHICAGO ST
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City | LINCOLN
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State | IL
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Zip | 62656-2719
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Country | US
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Telephone | 217-732-1122
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Fax | 217-732-1144
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Provider Business Mailing Address
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Address Line | 5533 W 109TH ST STE 101
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City | OAK LAWN
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State | IL
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Zip | 60453-5058
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Country | US
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Telephone | 708-424-9405
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Fax | 708-424-8038
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Authorized Official
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Title or Position | PRESIDENT
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Name | SAMI BAIG
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Credential |
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Telephone | 708-424-9405
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335V00000X
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Taxonomy Name | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 247100000X
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Taxonomy Name | Radiologic Technologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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