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Organization
SUBURBAN DIAGNOSTIC INC
Active
Organization
SUBURBAN DIAGNOSTIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLENN PADILLA RT (OWNER)
(815) 577-8200
Entity
Organization
Contact information
Practice address
11600 LEGACY DR, PLAINFIELD, IL 60585-5194
(815) 577-8200
(815) 577-8300
Mailing address
11600 LEGACY DR, PLAINFIELD, IL 60585-5194
(815) 577-8200
(815) 577-8300
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
500483643
IL
Other
Enumeration date
04/17/2007
Last updated
05/02/2012
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