Provider Demographics
NPI:1720038607
Name:QUALITY DIAGNOSTIC IMAGING,LLC
Entity Type:Organization
Organization Name:QUALITY DIAGNOSTIC IMAGING,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMIUDDIN
Authorized Official - Middle Name:SYED
Authorized Official - Last Name:KHAJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-297-6351
Mailing Address - Street 1:2202 WEBER RD
Mailing Address - Street 2:
Mailing Address - City:CREST HILL
Mailing Address - State:IL
Mailing Address - Zip Code:60435-0928
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2202 WEBER RD
Practice Address - Street 2:
Practice Address - City:CREST HILL
Practice Address - State:IL
Practice Address - Zip Code:60435-0928
Practice Address - Country:US
Practice Address - Phone:773-297-6351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL9257193335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier