Provider Demographics
NPI:1144570524
Name:EXCLUSIVE DIAGNOSTICS INC
Entity Type:Organization
Organization Name:EXCLUSIVE DIAGNOSTICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FEROZE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEIKH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-818-1275
Mailing Address - Street 1:6223 N CALIFORNIA AVE
Mailing Address - Street 2:SUITE G1
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-2666
Mailing Address - Country:US
Mailing Address - Phone:773-818-1275
Mailing Address - Fax:
Practice Address - Street 1:6223 N CALIFORNIA AVE
Practice Address - Street 2:SUITE G1
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-2666
Practice Address - Country:US
Practice Address - Phone:773-818-1275
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-13
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL7701Medicare UPIN