Organization
JR IMAGING MOBILE ULTRASOUND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSE BEJARANO (PRESIDENT)
(773) 710-4025
Entity
Organization
Contact information
Practice address
1778 HAWTHORNE TER, DES PLAINES, IL 60016-3529
(773) 710-4025
(773) 637-2006
Mailing address
1778 HAWTHORNE TER, DES PLAINES, IL 60016-3529
(773) 710-4025
(773) 637-2006
Taxonomy
Speciality
Code
Description
License number
State
2471S1302X
Sonography Radiologic Technologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01629945
BCBS
IL
Enumeration date
11/22/2006
Last updated
08/22/2020
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