Organization
FUTURE DIAGNOSTICS, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GRIGORIY CHECHELNITSKIY (OWNER)
(773) 274-7870
Entity
Organization
Contact information
Practice address
2804 W DEVON AVE, CHICAGO, IL 60659-1502
(773) 274-7870
(773) 274-7860
Mailing address
2804 W DEVON AVE, CHICAGO, IL 60659-1502
(773) 274-7870
(773) 274-7860
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01621502
BLUE CROSS BLUE SHIELD PR
IL
Enumeration date
01/05/2007
Last updated
08/22/2020
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