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Organization

INDIANA RADIOLOGY IMAGING CONSULTANTS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KYLE W. DWORCHAK (CHIEF FINANCIAL OFFICER)
(708) 915-5656
Entity
Organization

Contact information

Practice address
71 W 156TH ST, SUITE 110, HARVEY, IL 60426-4260
(708) 915-5656
(708) 915-4022
Mailing address
71 W 156TH ST, SUITE 110, HARVEY, IL 60426-4260
(708) 915-5656
(708) 915-4022

Taxonomy

Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
2085N0700X
Neuroradiology Physician
2085P0229X
Pediatric Radiology Physician
2085R0202X
Diagnostic Radiology Physician
Primary
2085R0204X
Vascular & Interventional Radiology Physician
2085U0001X
Diagnostic Ultrasound Physician

Other

Enumeration date
10/03/2013
Last updated
05/14/2014
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