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General NPI Number Information
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NPI Number | 1861491474
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Entity Type | Organization
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Legal Business Name | ACCURATE IMAGING DIAGNOSTIC, LTD.
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Dates
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Enumeration Date | 07/15/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3525 W PETERSON AVE SUITE 103
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City | CHICAGO
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State | IL
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Zip | 60659-3324
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Country | US
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Telephone | 773-588-8373
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Fax | 773-588-8391
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Provider Business Mailing Address
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Address Line | 3525 W PETERSON AVE SUITE 103
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City | CHICAGO
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State | IL
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Zip | 60659-3324
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Country | US
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Telephone | 773-588-8373
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Fax | 773-588-8391
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ROMAN BRUSILOVSKY
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Credential |
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Telephone | 773-588-8378
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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 | IL
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