Organization
CHICAGO RIDGE RADIOLOGY, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AATIF RAHMAN (ADMINISTRATOR)
(708) 423-1819
Entity
Organization
Contact information
Practice address
9830 RIDGELAND AVE, SUITE 4, CHICAGO RIDGE, IL 60415-2667
(708) 423-1819
(708) 423-4788
Mailing address
9830 RIDGELAND AVE, SUITE 4, CHICAGO RIDGE, IL 60415-2667
(708) 423-1819
(708) 423-4788
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1548282114
NPI
IL
Enumeration date
07/09/2012
Last updated
07/09/2012
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