Provider Demographics
NPI:1518042548
Name:TOUHY DIAGNOSTIC AT HOME, LLC
Entity Type:Organization
Organization Name:TOUHY DIAGNOSTIC AT HOME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SHABAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:DARVISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-803-1111
Mailing Address - Street 1:490 LEE ST
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-4646
Mailing Address - Country:US
Mailing Address - Phone:847-803-1111
Mailing Address - Fax:847-803-1114
Practice Address - Street 1:490 LEE ST
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-4646
Practice Address - Country:US
Practice Address - Phone:847-803-1111
Practice Address - Fax:847-803-1114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
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209529Medicare PIN