| NPI | 1952936239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALI POONAWALA Director 224-633-6856 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology |
| 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine | |
| 2085R0204X Radiology Vascular & Interventional Radiology | |
| Enumeration Date | 2020-03-07 |
| Last Update Date | 2020-03-07 |