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General NPI Number Information
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NPI Number | 1578920401
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Entity Type | Organization
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Legal Business Name | HOPE WOMEN'S IMAGING AND MEDICAL CENTER, LLC
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Dates
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Enumeration Date | 01/22/2016
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Last Update Date | 01/22/2016
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Provider Practice Location Address
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Address Line | 3517 W DEVON AVE
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City | CHICAGO
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State | IL
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Zip | 60659-1305
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Country | US
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Telephone | 847-927-9406
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Fax |
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Provider Business Mailing Address
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Address Line | 1378 MANASSAS CT
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City | LONG GROVE
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State | IL
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Zip | 60047-5084
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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 | CFO
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Name | OMAYR NIAZI
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Credential |
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Telephone | 847-927-9406
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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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Taxonomy #2
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number |
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License Number State |
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