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SUBURBAN DIAGNOSTIC INC NPI 1740406107


NPI Information

NPI: 1740406107
Provider Name: SUBURBAN DIAGNOSTIC INC
Classification: Portable X-ray and/or Other Portable Diagnostic Imaging Supplier - 335V00000X
Entity Type: Organization
Address:
11600 LEGACY DR
PLAINFIELD, IL
ZIP 60585
Phone: (815) 577-8200
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SUBURBAN DIAGNOSTIC INC is a portable x ray and or other portable diagnostic imaging supplier in Plainfield, 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. SUBURBAN DIAGNOSTIC INC NPI is 1740406107. The provider is registered as an organization entity type.

The provider's business location address is:

11600 LEGACY DR
PLAINFIELD, IL
ZIP 60585-194
Phone: (815) 577-8200
Fax: (815) 577-8300

The provider's authorized official is Glenn Padilla .
The authorized official title is Owner and has the following contact phone number (815) 577-8200.

The enumeration date for this NPI number is 4/17/2007 and was last updated on 5/2/2012.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1335V00000XPortable X-ray and/or Other Portable Diagnostic Imaging Supplier500483643ILLINOISYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1364369726001MEDICAIDILLINOIS
209932186OTHERILLINOISBCBS
3211705MEDICARE PINILLINOIS

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: 5/5/2024

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