| NPI | 1700831773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AJAY MALPANI President 309-452-1788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 042001755) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: IL 042001755) |
| 2085N0700X Radiology, Neuroradiology (Licence: IL 042001755) | |
| 2085N0904X Radiology, Nuclear Radiology (Licence: IL 042001755) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 042001755) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2021-05-27 |