Provider Demographics
NPI:1912162496
Name:PROGRESSIVE DIAGNOSTICS INC
Entity Type:Organization
Organization Name:PROGRESSIVE DIAGNOSTICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KUMUD
Authorized Official - Middle Name:
Authorized Official - Last Name:DHINGRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-904-8091
Mailing Address - Street 1:2646 W AUGUSTA BLVD UNIT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-6594
Mailing Address - Country:US
Mailing Address - Phone:630-946-4579
Mailing Address - Fax:630-206-1591
Practice Address - Street 1:2646 W AUGUSTA BLVD UNIT 2
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-6594
Practice Address - Country:US
Practice Address - Phone:630-946-4579
Practice Address - Fax:630-904-8091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-23
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3927-1129246XS1301X
246XS1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonographyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
76706OtherMEDICARE
76700OtherMEDICARE
76882OtherMEDICARE
76536OtherMEDICARE
76856OtherMEDICARE
76872OtherMEDICARE
76641OtherMEDICARE