| NPI | 1881975266 |
|---|---|
| Doing Business As | PORTRAIT HEALTH CENTERS DIAGNOSTIC SERVICES |
| Entity Type | Organization |
| Authorized Contact | JACK A MAGGIORE Director 847-868-3435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 293D00000X Physiological Laboratory |
| Additional Taxonomies | 103TH0100X Psychologist, Health Service |
| Enumeration Date | 2011-08-30 |
| Last Update Date | 2011-08-31 |