Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Mar 25, 2018
License(s)
342182 (LA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 5841 S MARYLAND AVE # MC2026 | Chicago, IL 60637-1443 | 202-877-3536 |
| MAILING | 5841 S MARYLAND AVE # MC2026 | Chicago, IL 60637-1443 | 888-824-0200 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.