# SUBURBAN DIAGNOSTIC INC

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

## Provider details

- **NPI number:** 1740406107
- **Authorized official:** GLENN PADILLA RT (OWNER)
- **Authorized official phone:** (815) 577-8200

## Contact information

- **Practice address:** 11600 LEGACY DR, PLAINFIELD, IL 60585-5194
- **Practice address phone:** (815) 577-8200
- **Practice address fax:** (815) 577-8300
- **Mailing address:** 11600 LEGACY DR, PLAINFIELD, IL 60585-5194
- **Mailing address phone:** (815) 577-8200
- **Mailing address fax:** (815) 577-8300

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 500483643 | IL | Yes |

## Other

- **Enumeration date:** 04/17/2007
- **Last updated:** 05/02/2012