Provider Demographics
NPI:1427000355
Name:DIAGNOSTICS, INC
Entity Type:Organization
Organization Name:DIAGNOSTICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DREW
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:ROSKOS
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:708-560-7316
Mailing Address - Street 1:17047 THACKERY ST
Mailing Address - Street 2:
Mailing Address - City:OAK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60452-4453
Mailing Address - Country:US
Mailing Address - Phone:708-560-7316
Mailing Address - Fax:708-560-7346
Practice Address - Street 1:17047 THACKERY ST
Practice Address - Street 2:
Practice Address - City:OAK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60452-4453
Practice Address - Country:US
Practice Address - Phone:708-560-7316
Practice Address - Fax:708-560-7346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1670467OtherBLUE CROSS/BLUE
IL1670467OtherBLUE CROSS/BLUE