Provider Demographics
NPI:1407461783
Name:ILLINOIS MOBILE IMAGING INC
Entity Type:Organization
Organization Name:ILLINOIS MOBILE IMAGING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMJAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ABUSENI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-769-9866
Mailing Address - Street 1:16170 QUAIL CT
Mailing Address - Street 2:
Mailing Address - City:ORLAND HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60487-5992
Mailing Address - Country:US
Mailing Address - Phone:708-769-9866
Mailing Address - Fax:
Practice Address - Street 1:16170 QUAIL CT
Practice Address - Street 2:
Practice Address - City:ORLAND HILLS
Practice Address - State:IL
Practice Address - Zip Code:60487-5992
Practice Address - Country:US
Practice Address - Phone:708-769-9866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-13
Last Update Date:2020-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty