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Organization

MIDWEST DIAGNOSTIC MANAGEMENT, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JON KNIPPER (CHIEF OPERATING OFFICER)
(708) 478-6434
Entity
Organization

Contact information

Practice address
19065 HICKORY CREEK PL, SUITE 240, MOKENA, IL 60448-8507
(708) 478-6417
(708) 535-8087
Mailing address
19065 HICKORY CREEK PL, SUITE 240, MOKENA, IL 60448-8507
(708) 478-6417
(708) 535-8087

Taxonomy

Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary

Other

Enumeration date
03/24/2007
Last updated
12/10/2008
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