Provider Demographics
NPI:1649607623
Name:TOUHY DIAGNOSTIC AT HOME LLC
Entity type:Organization
Organization Name:TOUHY DIAGNOSTIC AT HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SALIM
Authorized Official - Middle Name:
Authorized Official - Last Name:UDDIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-803-1111
Mailing Address - Street 1:1293 RAND RD
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-3402
Mailing Address - Country:US
Mailing Address - Phone:847-803-1111
Mailing Address - Fax:
Practice Address - Street 1:723 58TH ST
Practice Address - Street 2:304
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53140-4160
Practice Address - Country:US
Practice Address - Phone:847-803-1111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-04
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology