Organization
DAV-KIM PORTABLE X RAY SERVICE CO
Active
Other names
ALL-STAT PORTABLE XRAY
Organization subpart
No
Provider details
NPI number
Authorized official
ETAI SOOLIMAN (CEO)
(224) 337-1000
Entity
Organization
Contact information
Practice address
8235 CHRISTIANA AVE, SKOKIE, IL 60076-2910
(224) 337-1000
(224) 337-0100
Mailing address
PO BOX 1126, NORTHBROOK, IL 60065-1126
(224) 337-1000
(224) 337-0100
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
791630010
RAILROAD MEDICARE
—
Enumeration date
10/08/2008
Last updated
07/21/2022
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