Provider Demographics
NPI:1568652428
Name:POLSONO MOBILE ULTRASOUND, P.C.
Entity Type:Organization
Organization Name:POLSONO MOBILE ULTRASOUND, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BOWEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-428-9629
Mailing Address - Street 1:1030 N STATE ST APT 17H
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-5492
Mailing Address - Country:US
Mailing Address - Phone:847-428-9629
Mailing Address - Fax:630-423-9549
Practice Address - Street 1:1030 N STATE ST APT 17H
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-5492
Practice Address - Country:US
Practice Address - Phone:847-428-9629
Practice Address - Fax:630-423-9549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Single Specialty