Provider Demographics
NPI:1093827297
Name:MEDTEK DIAGNOSTICS INC
Entity Type:Organization
Organization Name:MEDTEK DIAGNOSTICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAQSOOD
Authorized Official - Middle Name:
Authorized Official - Last Name:JAFRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-747-3364
Mailing Address - Street 1:203 CHANTICLEER LN
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-5022
Mailing Address - Country:US
Mailing Address - Phone:630-747-3364
Mailing Address - Fax:
Practice Address - Street 1:201 E ARMY TRAIL RD
Practice Address - Street 2:STE 204
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-2150
Practice Address - Country:US
Practice Address - Phone:630-671-8346
Practice Address - Fax:630-671-8301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001635998OtherBLUE CROSS BLUE SHIELD
IL036099382Medicaid
IL0001635998OtherBLUE CROSS BLUE SHIELD