Provider Demographics
NPI:1093887275
Name:BIO IMAGE INC
Entity type:Organization
Organization Name:BIO IMAGE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIRIL
Authorized Official - Middle Name:P
Authorized Official - Last Name:PEEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-986-1573
Mailing Address - Street 1:601 LAKE HINSDALE DRIVE
Mailing Address - Street 2:SUITE # 208
Mailing Address - City:WILLOWBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60527
Mailing Address - Country:US
Mailing Address - Phone:630-986-1573
Mailing Address - Fax:630-789-0496
Practice Address - Street 1:601 LAKE HINSDALE DRIVE
Practice Address - Street 2:SUITE # 208
Practice Address - City:WILLOWBROOK
Practice Address - State:IL
Practice Address - Zip Code:60527
Practice Address - Country:US
Practice Address - Phone:630-986-1573
Practice Address - Fax:630-789-0496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001630340OtherBC BS OF IL
IL=========001Medicaid
IL200839Medicare ID - Type Unspecified