Provider Demographics
NPI:1376665224
Name:ULTRASOUND OF BELVIDERE LLC
Entity Type:Organization
Organization Name:ULTRASOUND OF BELVIDERE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SABITOSRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-988-3642
Mailing Address - Street 1:1006 LOGAN AVENUE
Mailing Address - Street 2:
Mailing Address - City:BELVIDERE
Mailing Address - State:IL
Mailing Address - Zip Code:61008
Mailing Address - Country:US
Mailing Address - Phone:815-988-3642
Mailing Address - Fax:815-544-4775
Practice Address - Street 1:1006 LOGAN AVENUE
Practice Address - Street 2:
Practice Address - City:BELVIDERE
Practice Address - State:IL
Practice Address - Zip Code:61008
Practice Address - Country:US
Practice Address - Phone:815-988-3642
Practice Address - Fax:815-544-4775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Multi-Specialty
No2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiographyGroup - Multi-Specialty