# MINIMALLY INVASIVE THERAPY PARTNERS SC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mobile Intervention and Diagnostic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659739910
- **Authorized official:** DR. IFTIKHAR AHMAD MD (PRESIDENT AND CEO)
- **Authorized official phone:** (844) 834-6362

## Contact information

- **Practice address:** 5011 N LINCOLN AVE, CHICAGO, IL 60625-6351
- **Practice address phone:** (844) 834-6362
- **Practice address fax:** (855) 497-2932
- **Mailing address:** 5011 N LINCOLN AVE, CHICAGO, IL 60625-6351
- **Mailing address phone:** (844) 834-6362
- **Mailing address fax:** (855) 497-2932

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | — | IL | Yes |

## Other

- **Enumeration date:** 02/02/2016
- **Last updated:** 03/01/2017