Provider Demographics
NPI:1639205883
Name:DR DIAGNOSTIC INC
Entity Type:Organization
Organization Name:DR DIAGNOSTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:VALERY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROYTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-620-7130
Mailing Address - Street 1:7933 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-3632
Mailing Address - Country:US
Mailing Address - Phone:773-620-7130
Mailing Address - Fax:773-545-9895
Practice Address - Street 1:7933 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-3632
Practice Address - Country:US
Practice Address - Phone:773-620-7130
Practice Address - Fax:773-545-9895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier