Organization
IBRAHEEM IMAGING SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUEA HOSNEY IBRAHEEM (OWNER)
(414) 438-6666
Entity
Organization
Contact information
Practice address
5330 W VILLARD AVE, MILWAUKEE, WI 53218-4345
(414) 438-6666
(414) 438-6667
Mailing address
PO BOX 639, THIENSVILLE, WI 53092-0639
(414) 247-9005
(414) 247-9004
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
—
56828
ARDMS
WI
Enumeration date
08/18/2021
Last updated
08/18/2021
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