MEDICARE: DIAGNOSTIC IMAGING SERVICES 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	207RC0000X	Cardiovascular Disease Physician
2	2085R0202X	Diagnostic Radiology Physician

General Provider Information

NPI Number	:	1841241064
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIAGNOSTIC IMAGING SERVICES INC

Provider Business Mailing Address
First Line	:	520 E 22ND ST
Second Line	:
City	:	LOMBARD
State	:	IL
Zip	:	60148-6110
Country	:	US
Telephone Number	:	630-874-2542
Fax Number	:

Provider Business Practice Location Address
First Line	:	721 W HIGHWAY 22
Second Line	:
City	:	LAKE ZURICH
State	:	IL
Zip	:	60047-2552
Country	:	US
Telephone Number	:	847-438-0181
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	SAM RISHI
Credential	:
Telephone Number	:	847-438-0181

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	07/16/2007

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Directions to “DIAGNOSTIC IMAGING SERVICES INC ” Practice Location

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