Provider Demographics
NPI:1275233108
Name:CIMPAR DIAGNOSTICS LLC
Entity Type:Organization
Organization Name:CIMPAR DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO/CFO
Authorized Official - Prefix:
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-415-4030
Mailing Address - Street 1:101 MADISON ST STE 300
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-4210
Mailing Address - Country:US
Mailing Address - Phone:773-849-9406
Mailing Address - Fax:
Practice Address - Street 1:101 MADISON ST STE 300
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-4210
Practice Address - Country:US
Practice Address - Phone:773-849-9406
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
No335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier