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General NPI Number Information
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NPI Number | 1770976979
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Entity Type | Organization
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Legal Business Name | ECUAMACHINES INC.
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Dates
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Enumeration Date | 03/11/2015
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Last Update Date | 03/11/2015
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Provider Practice Location Address
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Address Line | 3149 S KARLOV AVE
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City | CHICAGO
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State | IL
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Zip | 60623-4818
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Country | US
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Telephone | 773-968-6549
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Fax |
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Provider Business Mailing Address
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Address Line | 3149 S KARLOV AVE
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City | CHICAGO
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State | IL
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Zip | 60623-4818
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Country | US
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Telephone | 773-968-6549
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Fax |
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Authorized Official
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Title or Position | SONOGRAPHER
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Name | MR. CARLOS M. EGAS
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Credential | REGISTERED US TECH
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Telephone | 773-971-6481
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number | 132956
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License Number State | IL
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