Provider Demographics
NPI:1770883779
Name:S & S DIAGNOSTIC SERVICES, INC
Entity type:Organization
Organization Name:S & S DIAGNOSTIC SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:THASEEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-484-9761
Mailing Address - Street 1:3245 GROVE AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-3474
Mailing Address - Country:US
Mailing Address - Phone:708-484-9761
Mailing Address - Fax:708-484-7131
Practice Address - Street 1:3245 GROVE AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-3474
Practice Address - Country:US
Practice Address - Phone:708-484-9761
Practice Address - Fax:708-484-7131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory