Provider Demographics
NPI:1649945098
Name:MBSS IMAGING MASTERS, LLC
Entity type:Organization
Organization Name:MBSS IMAGING MASTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:GANATRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-749-4583
Mailing Address - Street 1:2500 S HIGHLAND AVE STE 330
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-5390
Mailing Address - Country:US
Mailing Address - Phone:847-749-4583
Mailing Address - Fax:847-742-4596
Practice Address - Street 1:2500 S HIGHLAND AVE STE 330
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-5390
Practice Address - Country:US
Practice Address - Phone:847-749-4583
Practice Address - Fax:847-742-4596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-09
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile