Provider Demographics
NPI:1427374040
Name:MOBILE DIAGNOSTIC CARE, INC.
Entity Type:Organization
Organization Name:MOBILE DIAGNOSTIC CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SERGEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GLIKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-956-3018
Mailing Address - Street 1:2970 MARIA AVE
Mailing Address - Street 2:SUITE 115
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2017
Mailing Address - Country:US
Mailing Address - Phone:847-956-3018
Mailing Address - Fax:847-537-5544
Practice Address - Street 1:2970 MARIA AVE
Practice Address - Street 2:SUITE 115
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-2017
Practice Address - Country:US
Practice Address - Phone:847-956-3018
Practice Address - Fax:847-537-5544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-08
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile