Provider Demographics
NPI:1073353157
Name:PSC CARDIORAD LLC
Entity type:Organization
Organization Name:PSC CARDIORAD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:SAKARIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:331-230-2500
Mailing Address - Street 1:1323 BUTTERFIELD RD STE 108
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-5620
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1323 BUTTERFIELD RD STE 108
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-5620
Practice Address - Country:US
Practice Address - Phone:331-230-2500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
No246X00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularGroup - Multi-Specialty
No293D00000XLaboratoriesPhysiological Laboratory