Organization
GESL MEDICAL IMAGING MD SC LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GUSTAVO E SARAVIA M.D. (PRESIDENT)
(708) 386-3679
Entity
Organization
Contact information
Practice address
930 FOREST AVE, OAK PARK, IL 60302-1310
(708) 386-3679
(708) 386-3679
Mailing address
930 FOREST AVE, OAK PARK, IL 60302-1310
(708) 386-3679
(708) 386-3679
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036066365
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036066365
—
IL
Enumeration date
09/01/2009
Last updated
09/01/2009
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