Organization
MIDWEST DIAGNOSTICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDIE NAPIENTEK (PAYER CONTRACTING)
(630) 399-5940
Entity
Organization
Contact information
Practice address
3330 W 177TH ST, SUITE 2C, HAZEL CREST, IL 60429-2184
(170) 879-9114
Mailing address
3330 W 177TH ST, SUITE 2C, HAZEL CREST, IL 60429-2184
(170) 879-9114
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
036074003
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01638865
BLUE CROSS BLUE SHIELD
IL
Enumeration date
01/23/2008
Last updated
05/21/2009
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