Provider Demographics
NPI:1356893952
Name:AQUEST IMAGING, LLC
Entity type:Organization
Organization Name:AQUEST IMAGING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:QUENNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEL ROSARIO
Authorized Official - Suffix:
Authorized Official - Credentials:RDMS, RVT
Authorized Official - Phone:773-240-9187
Mailing Address - Street 1:4814 N CENTRAL PARK AVE
Mailing Address - Street 2:APT 1
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-5686
Mailing Address - Country:US
Mailing Address - Phone:773-240-9187
Mailing Address - Fax:
Practice Address - Street 1:4814 N CENTRAL PARK AVE
Practice Address - Street 2:APT 1
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-5686
Practice Address - Country:US
Practice Address - Phone:773-240-9187
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-29
Last Update Date:2016-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center