Provider Demographics
NPI:1518269935
Name:CLOSER LOOK IMAGING LLC
Entity Type:Organization
Organization Name:CLOSER LOOK IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SAMEER
Authorized Official - Middle Name:
Authorized Official - Last Name:SUHAIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-363-8080
Mailing Address - Street 1:7431 S EAST END AVE UNIT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60649-3611
Mailing Address - Country:US
Mailing Address - Phone:773-363-8080
Mailing Address - Fax:773-891-4905
Practice Address - Street 1:7431 S EAST END AVE UNIT 2
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60649-3611
Practice Address - Country:US
Practice Address - Phone:773-363-8080
Practice Address - Fax:773-891-4905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-18
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361015862085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty