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Organization
IDEAL HEALTH DIAGNOSTICS, INC.
Active
Organization
IDEAL HEALTH DIAGNOSTICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SVETLANA DIZIK (PRESIDENT)
(847) 293-7704
Entity
Organization
Contact information
Practice address
145 W DUNDEE RD, BUFFALO GROVE, IL 60089-3706
(847) 293-7704
Mailing address
145 W DUNDEE RD, BUFFALO GROVE, IL 60089-3706
(847) 293-7704
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01629955
BCBS PROVIDER NUMBER
IL
01
—
626700
GROUP PIN #
IL
Enumeration date
10/16/2006
Last updated
08/22/2020
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