Organization
MIDWEST DIAGNOSTIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SYED RIAZUL HASSAN (PRESIDENT/ADMINISTRATOR)
(773) 392-6888
Entity
Organization
Contact information
Practice address
2600 W PETERSON AVE, CHICAGO, IL 60659-4098
(773) 944-5775
(773) 944-9779
Mailing address
2600 W PETERSON AVE, CHICAGO, IL 60659-4098
(773) 944-5775
(773) 944-9779
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
05/19/2006
Last updated
08/22/2020
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