Provider Demographics
NPI:1881027860
Name:ILLINOIS IMAGING, INC.
Entity Type:Organization
Organization Name:ILLINOIS IMAGING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:TURCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-620-3600
Mailing Address - Street 1:4044 N LINCOLN AVE
Mailing Address - Street 2:SUITE 377
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-3038
Mailing Address - Country:US
Mailing Address - Phone:561-620-3600
Mailing Address - Fax:
Practice Address - Street 1:4044 N LINCOLN AVE
Practice Address - Street 2:SUITE 377
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-3038
Practice Address - Country:US
Practice Address - Phone:561-620-3600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-14
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)