Basic Information
| Provider Information | |||||||||
| NPI: | 1265758247 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EDWARD HOSPITAL IMAGING CENTER BOOK RD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 801 S WASHINGTON ST | ||||||||
| Address2: | |||||||||
| City: | NAPERVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605407430 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6305273000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2007 95TH ST | ||||||||
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| City: | NAPERVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605648459 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6305273200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/15/2010 | ||||||||
| LastUpdateDate: | 04/16/2010 | ||||||||
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| AuthorizedOfficialLastName: | DAVIS | ||||||||
| AuthorizedOfficialFirstName: | PAM | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT AND CEO | ||||||||
| AuthorizedOfficialTelephone: | 6305273010 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0200X | IL | Y | Ambulatory Health Care Facilities | Clinic/Center | Radiology |
No ID Information.