Organization
MIDLICK'S MEDICAL IMAGING INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID GEORGE MIDLICK (PRESIDENT OWNER)
(630) 663-9811
Entity
Organization
Contact information
Practice address
6686 DOUBLE EAGLE DR, UNIT 103, WOODRIDGE, IL 60517-5428
(630) 663-9811
(630) 663-9018
Mailing address
6686 DOUBLE EAGLE DR, UNIT 103, WOODRIDGE, IL 60517-5428
(630) 663-9811
(630) 663-9018
Taxonomy
Speciality
Code
Description
License number
State
2085U0001X
Diagnostic Ultrasound Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02230031
BLUE CROSS BLUE SHIELD
IL
01
—
02230032
BLUE CROSS BLUE SHIELD
IL
Enumeration date
12/11/2006
Last updated
01/11/2017
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