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General NPI Number Information
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NPI Number | 1669483988
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Entity Type | Organization
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Legal Business Name | METROPOLITAN DIAGNOSTIC IMAGING
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1332 E 47TH ST
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City | CHICAGO
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State | IL
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Zip | 60653-4508
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Country | US
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Telephone | 773-624-5400
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Fax | 773-624-5408
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Provider Business Mailing Address
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Address Line | 111 N WABASH AVE SUITE 620
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City | CHICAGO
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State | IL
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Zip | 60602-1903
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Country | US
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Telephone | 312-807-3555
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Fax | 312-807-3922
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Authorized Official
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Title or Position | PRESIDENT/MEDICAL DIRECTOR
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Name | JOEL LELAND
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Credential | DO
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Telephone | 312-807-3555
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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 |
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License Number State |
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