Provider Demographics
NPI:1720366701
Name:DAWN DIAGNOSTICS IMAGING GROUP INC.
Entity Type:Organization
Organization Name:DAWN DIAGNOSTICS IMAGING GROUP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IMITIAZ
Authorized Official - Middle Name:H
Authorized Official - Last Name:AWAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-840-6761
Mailing Address - Street 1:PO BOX 597261
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-7261
Mailing Address - Country:US
Mailing Address - Phone:847-840-6761
Mailing Address - Fax:
Practice Address - Street 1:2900 W PETERSON AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-3818
Practice Address - Country:US
Practice Address - Phone:847-840-6761
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-25
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier