Provider Demographics
NPI:1467766303
Name:MDS DIGITAL PORTABLE X-RAY INC.
Entity Type:Organization
Organization Name:MDS DIGITAL PORTABLE X-RAY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MUNEER
Authorized Official - Middle Name:S
Authorized Official - Last Name:HASAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-544-1249
Mailing Address - Street 1:3701 JARVIS AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-4019
Mailing Address - Country:US
Mailing Address - Phone:847-606-0800
Mailing Address - Fax:847-626-0819
Practice Address - Street 1:10300 W LINCOLN AVE
Practice Address - Street 2:SUITE LL
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53227-2100
Practice Address - Country:US
Practice Address - Phone:414-321-6666
Practice Address - Fax:888-734-0535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-03
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty