Organization
RADRAD GROUP OF IL SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TENNYSON MALIRO MD (OWNER/PROVIDER/AUTHORIZED REP)
(301) 503-9055
Entity
Organization
Contact information
Practice address
500 N MCLEAN BLVD # 103, ELGIN, IL 60123-3275
(224) 227-6178
(224) 227-6178
Mailing address
PO BOX 7065, LOVELAND, CO 80537-0065
(970) 663-2742
(970) 667-0847
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
03/30/2023
Last updated
06/02/2023
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