Provider Demographics
NPI:1114117017
Name:QUALITY DIAGNOSTIC ULTRASOUND, CORP
Entity Type:Organization
Organization Name:QUALITY DIAGNOSTIC ULTRASOUND, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELZBIETA
Authorized Official - Middle Name:
Authorized Official - Last Name:OSTOJA
Authorized Official - Suffix:
Authorized Official - Credentials:RDMS
Authorized Official - Phone:773-736-1762
Mailing Address - Street 1:4815 W BELLE PLAINE AVE APT 209
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-1841
Mailing Address - Country:US
Mailing Address - Phone:773-736-1762
Mailing Address - Fax:
Practice Address - Street 1:4815 W BELLE PLAINE AVE APT 209
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-1841
Practice Address - Country:US
Practice Address - Phone:773-736-1762
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RDMS 117674261QR0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile