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Organization

DAV-KIM PORTABLE X RAY SERVICE CO

Active
Other names
ALL-STAT PORTABLE XRAY
Organization subpart
No

Provider details

NPI number
Authorized official
MR. 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
2085R0202X
Diagnostic Radiology Physician
Primary
320700000X
Physical Disabilities Residential Treatment Facility

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
206164
MEDICARE PTAN
01
CM7408
RAILROAD MEDICARE
Enumeration date
11/01/2006
Last updated
07/21/2022
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