Provider Demographics
NPI:1801037825
Name:URGENT MEDICAL DIAGNOSTIC, INC
Entity Type:Organization
Organization Name:URGENT MEDICAL DIAGNOSTIC, INC
Other - Org Name:URGENT MEDICAL IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:HUSSAIN
Authorized Official - Last Name:MUQEEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-216-3344
Mailing Address - Street 1:799 ROOSEVELT RD
Mailing Address - Street 2:BUILDING 3, SUITE 209C
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137-5908
Mailing Address - Country:US
Mailing Address - Phone:773-216-3344
Mailing Address - Fax:
Practice Address - Street 1:799 ROOSEVELT RD
Practice Address - Street 2:BUILDING 3, SUITE 209C
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-5908
Practice Address - Country:US
Practice Address - Phone:773-216-3344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-20
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile