Provider Demographics
NPI:1740404425
Name:DIAGNOSTIC ULTRASOUND CONSULTANTS LTD
Entity Type:Organization
Organization Name:DIAGNOSTIC ULTRASOUND CONSULTANTS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:C
Authorized Official - Last Name:BIRNHOLZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-954-5577
Mailing Address - Street 1:120 OAKBROOK CTR
Mailing Address - Street 2:SUITE 408
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1806
Mailing Address - Country:US
Mailing Address - Phone:630-954-5577
Mailing Address - Fax:630-954-2919
Practice Address - Street 1:120 OAKBROOK CTR
Practice Address - Street 2:SUITE 408
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1806
Practice Address - Country:US
Practice Address - Phone:630-954-5577
Practice Address - Fax:630-954-2919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36-065383261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL935870Medicare PIN
ILA43566Medicare UPIN