Provider Demographics
NPI:1629643200
Name:MOBILE MEDICAL DIAGNOSTIC INC
Entity Type:Organization
Organization Name:MOBILE MEDICAL DIAGNOSTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGAYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-946-8555
Mailing Address - Street 1:2146 N NASHVILLE AVE UNIT 1N
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60707-3950
Mailing Address - Country:US
Mailing Address - Phone:630-946-8555
Mailing Address - Fax:
Practice Address - Street 1:2146 N NASHVILLE AVE UNIT 1N
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60707-3950
Practice Address - Country:US
Practice Address - Phone:630-946-8555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-25
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225B00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPulmonary Function TechnologistGroup - Multi-Specialty