# SOUMA DIAGNOSTICS, LTD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104953017
- **Authorized official:** DR. RUDY E SABBAGH MD,FACOG (MEDICAL DIRECTOR)
- **Authorized official phone:** (312) 654-9100

## Contact information

- **Practice address:** 680 N LAKE SHORE DR, SUITE 1429, CHICAGO, IL 60611-4546
- **Practice address phone:** (312) 654-9100
- **Practice address fax:** (312) 654-9202
- **Mailing address:** PO BOX 11690, CHICAGO, IL 60611-0690
- **Mailing address phone:** (773) 735-2110
- **Mailing address fax:** (773) 735-4238

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085U0001X | Diagnostic Ultrasound Physician | — | IL | Yes |

## Other

- **Enumeration date:** 02/27/2007
- **Last updated:** 08/22/2020