# METRO PORTABLE X-RAY SERVICE

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

## Provider details

- **NPI number:** 1760697775
- **Authorized official:** DR. MILROY S EMMANUEL MD (PRESIDENT)
- **Authorized official phone:** (773) 736-1402

## Contact information

- **Practice address:** 4955 N MILWAUKEE AVE, SUITE 1, CHICAGO, IL 60630-2286
- **Practice address phone:** (773) 736-1402
- **Practice address fax:** (773) 736-1403
- **Mailing address:** 4955 N MILWAUKEE AVE, SUITE 1, CHICAGO, IL 60630-2286
- **Mailing address phone:** (773) 736-1402
- **Mailing address fax:** (773) 736-1403

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 042006693036046595 | IL | Yes |

## Other

- **Enumeration date:** 05/12/2007
- **Last updated:** 08/22/2020