| NPI | 1376295832 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NAOMI M CASSIN A VP, Provider Enrollment 312-724-8477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0208X Clinic/Center, Radiology, Mobile |
| Enumeration Date | 2022-01-25 |
| Last Update Date | 2022-12-14 |