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Organization

LAKEVIEW DIAGNOSTICS INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AZAM ABBASI (PRESIDENT)
(773) 910-0193
Entity
Organization

Contact information

Practice address
708 LAVERGNE AVE, WILMETTE, IL 60091-2028
(773) 910-0193
(773) 637-2006
Mailing address
708 LAVERGNE AVE, WILMETTE, IL 60091-2028
(773) 910-0193
(773) 637-2006

Taxonomy

Speciality
Code
Description
License number
State
2471S1302X
Sonography Radiologic Technologist
Primary
036064756
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036064756
IL
01
1633943
BLUE SHIELD OF IL
IL
Enumeration date
09/14/2006
Last updated
04/20/2016
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