Provider Demographics
NPI:1518918747
Name:DIAGNOSTIC SOLUTIONS, INC.
Entity Type:Organization
Organization Name:DIAGNOSTIC SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:EUGENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLF
Authorized Official - Suffix:
Authorized Official - Credentials:RDMS, RDCS, RVT
Authorized Official - Phone:630-462-9317
Mailing Address - Street 1:1730 AVALON CT
Mailing Address - Street 2:
Mailing Address - City:GLENDALE HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60139-1895
Mailing Address - Country:US
Mailing Address - Phone:630-462-9317
Mailing Address - Fax:630-462-0529
Practice Address - Street 1:1730 AVALON CT
Practice Address - Street 2:
Practice Address - City:GLENDALE HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60139-1895
Practice Address - Country:US
Practice Address - Phone:630-462-9317
Practice Address - Fax:630-462-0529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2232473OtherIL BLUE CROSS BLUE SHIELD
ILP00212568OtherRETIRED RAILROAD MEDICARE
IL2232473OtherIL BLUE CROSS BLUE SHIELD
IL=========001 1Medicaid