| NPI | 1740406107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN PADILLA Owner 815-577-8200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335V00000X Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier (Licence: IL 500483643) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2012-05-02 |