Basic Information
| Provider Information | |||||||||
| NPI: | 1417018318 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MEDICAL IMAGING SERVICES, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7531 S STONY ISLAND AVE | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606493954 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7739477781 | ||||||||
| FaxNumber: | 7739477792 | ||||||||
| Practice Location | |||||||||
| Address1: | 7531 S STONY ISLAND AVE | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606493954 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7739477781 | ||||||||
| FaxNumber: | 7739477792 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/13/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | FRIEDELL | ||||||||
| AuthorizedOfficialFirstName: | PETER | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7739477781 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M. D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM1200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Magnetic Resonance Imaging (MRI) |
No ID Information.