Provider Demographics
NPI:1083637417
Name:HIAS DIAGNOSTICS INC
Entity Type:Organization
Organization Name:HIAS DIAGNOSTICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROYTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-456-7130
Mailing Address - Street 1:4340 W HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646
Mailing Address - Country:US
Mailing Address - Phone:773-456-7130
Mailing Address - Fax:847-972-1867
Practice Address - Street 1:4023 CHURCH STREET
Practice Address - Street 2:A
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076
Practice Address - Country:US
Practice Address - Phone:847-816-6747
Practice Address - Fax:847-972-1867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2085U0001X
IL036063273335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036063273Medicaid
IL036063273Medicaid