Organization
ADVANCED HEALTHCARE RESOURCES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAYMOND STACHOWIAK (PRESIDENT)
(630) 483-3980
Entity
Organization
Contact information
Practice address
4212 N 16TH ST, ATTN CT SCANNER, PHOENIX, AZ 85016-5319
(602) 263-1626
(602) 263-1627
Mailing address
801 PHOENIX LAKE AVE, STREAMWOOD, IL 60107-2363
(630) 483-3980
(630) 483-3986
Taxonomy
Speciality
Code
Description
License number
State
2471C3401X
Computed Tomography Radiologic Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144866
—
AZ
01
—
AZ0813860
AZ BCBS PROV ID
AZ
Enumeration date
01/16/2007
Last updated
10/18/2011
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