Provider Demographics
NPI:1740079250
Name:UPTOWN ULTRASOUND LLC
Entity type:Organization
Organization Name:UPTOWN ULTRASOUND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOSIC
Authorized Official - Suffix:
Authorized Official - Credentials:CCI
Authorized Official - Phone:708-745-0707
Mailing Address - Street 1:4950 N MARINE DR APT 407
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-3911
Mailing Address - Country:US
Mailing Address - Phone:708-745-0707
Mailing Address - Fax:
Practice Address - Street 1:4950 N MARINE DR APT 407
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-3911
Practice Address - Country:US
Practice Address - Phone:708-745-0707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile