MEDICARE: INFINITE IMAGING INC

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
1	261QR0208X	Mobile Radiology Clinic/Center	054013996	IL

General Provider Information

NPI Number	:	1598720088
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INFINITE IMAGING INC

Provider Business Mailing Address
First Line	:	432 STONEGATE CT
Second Line	:
City	:	WILLOW BROOK
State	:	IL
Zip	:	60527-5451
Country	:	US
Telephone Number	:	773-925-6300
Fax Number	:	773-928-5662

Provider Business Practice Location Address
First Line	:	1029 E 30TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60827
Country	:	US
Telephone Number	:	773-928-6300
Fax Number	:	773-928-6850

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. VIJAY DOSHETTY
Credential	:	MD
Telephone Number	:	773-928-6300

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	04/22/2008

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