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MDS-MOBILE DIAGNOSTIC SERVICES INC NPI 1669430690


NPI Information

NPI: 1669430690
Provider Name: MDS-MOBILE DIAGNOSTIC SERVICES, INC

Other Name: MDS

Classification: Portable X-ray and/or Other Portable Diagnostic Imaging Supplier - 335V00000X
Entity Type: Organization
Address:
8770 W BRYN MAWR AVE
CHICAGO, IL
ZIP 60631
Phone: (773) 253-4963
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MDS-MOBILE DIAGNOSTIC SERVICES, INC is a portable x ray and or other portable diagnostic imaging supplier in Chicago, IL. The provider is a supplier that provides one or more of the following portable services, including but not limited to, x-ray, electrocardiogram (EKG), long-term EKG (Holter Monitor), bone densitometry, sonography, and other imaging services in accordance with all state and federal requirements, under the general supervision of a qualified physician. All necessary resources are transported to the patient's location where the services are performed. MDS-MOBILE DIAGNOSTIC SERVICES, INC NPI is 1669430690. The provider is registered as an organization entity type.
The provider Other Name Is Mds.

The provider's business location address is:

8770 W BRYN MAWR AVE
CHICAGO, IL
ZIP 60631-515
Phone: (773) 253-4963

The provider's authorized official is Faith A Campbell .
The authorized official title is President and has the following contact phone number (217) 378-4588.

The enumeration date for this NPI number is 5/1/2006 and was last updated on 3/25/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1335V00000XPortable X-ray and/or Other Portable Diagnostic Imaging SupplierYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1=========001MEDICAIDILLINOISIL MEDICAID PROVIDER NUMB
2213835MEDICARE ID-TYPE UNSPECIFIEDILLINOISMEDICARE PROVIDER NUMBER
3=========001MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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