Provider Demographics
NPI:1932289444
Name:E PLUS HEALTHCARE XV, LLC
Entity Type:Organization
Organization Name:E PLUS HEALTHCARE XV, LLC
Other - Org Name:PET IMAGING OF CHICAGO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:M
Authorized Official - Last Name:EYLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-467-7408
Mailing Address - Street 1:6801 34TH ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-5473
Mailing Address - Country:US
Mailing Address - Phone:708-484-8960
Mailing Address - Fax:708-484-9153
Practice Address - Street 1:6801 34TH ST
Practice Address - Street 2:SUITE 105
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-5473
Practice Address - Country:US
Practice Address - Phone:708-484-8960
Practice Address - Fax:708-484-9153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology