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NPI Code Detail

MEDICARE: ULTRAVISION IMAGING

MEDICARE: ULTRAVISION IMAGING
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician

General Provider Information

NPI Number : 1144233107
Entity Type Code : Organization
Provider Name (Legal Business Name) : ULTRAVISION IMAGING
Provider Business Mailing Address
First Line : 1825 SYLVAN CT
Second Line :
City : FLOSSMOOR
State : IL
Zip : 60422-1945
Country : US
Telephone Number : 708-957-3661
Fax Number : 708-923-3611
Provider Business Practice Location Address
First Line : 11800 SOUTHWEST HWY
Second Line :
City : PALOS HEIGHTS
State : IL
Zip : 60463-1029
Country : US
Telephone Number : 708-361-0220
Fax Number : 708-923-3611
Authorized Official
Title or Position : PRESIDENT
Name : DR. SANDRA WILLNER HOROWITZ
Credential : M.D.
Telephone Number : 708-957-3661
Provider Enumeration Date : 08/14/2006
Last Update Date : 06/24/2008

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Directions to “ULTRAVISION IMAGING ” Practice Location

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