Provider Demographics
NPI:1356102982
Name:MIDWESTERN PULMONARY DIAGNOSTICS, P.L.L.C.
Entity type:Organization
Organization Name:MIDWESTERN PULMONARY DIAGNOSTICS, P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARO
Authorized Official - Middle Name:
Authorized Official - Last Name:GHAZARIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, RRT-ACCS
Authorized Official - Phone:781-698-8939
Mailing Address - Street 1:5145 N CLARK ST # 1051
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-2829
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5145 N CLARK ST # 1051
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-2829
Practice Address - Country:US
Practice Address - Phone:781-698-8939
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-22
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2279P1004XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPulmonary DiagnosticsGroup - Multi-Specialty
No2279P1006XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPulmonary Function TechnologistGroup - Multi-Specialty