Provider Demographics
NPI:1316377682
Name:SPRING VIEW IMAGING CENTER
Entity Type:Organization
Organization Name:SPRING VIEW IMAGING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCKHALTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-338-7556
Mailing Address - Street 1:4343 OLD GRAND AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031
Mailing Address - Country:US
Mailing Address - Phone:847-338-7556
Mailing Address - Fax:847-672-7691
Practice Address - Street 1:4343 OLD GRAND AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-2767
Practice Address - Country:US
Practice Address - Phone:847-338-7556
Practice Address - Fax:847-672-7691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-22
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology