Organization
MIDWEST IMAGING & DIAGNOSTIC CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SULTAN TAHER (OWNER)
(708) 423-9982
Entity
Organization
Contact information
Practice address
5702 W 95TH ST, SUITE A, OAK LAWN, IL 60453-2345
(708) 423-9982
(708) 423-9984
Mailing address
5702 W 95TH ST, SUITE A, OAK LAWN, IL 60453-2345
(708) 423-9982
(708) 423-9984
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
212863
PTAN
IL
Enumeration date
06/04/2006
Last updated
03/20/2024
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