Provider Demographics
NPI:1386692655
Name:DIAGNOSTIC HEALTH CORPORATION
Entity type:Organization
Organization Name:DIAGNOSTIC HEALTH CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BURCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-653-8464
Mailing Address - Street 1:270 W LOOP RD
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-1034
Mailing Address - Country:US
Mailing Address - Phone:630-653-8464
Mailing Address - Fax:630-653-8660
Practice Address - Street 1:270 W LOOP RD
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-1034
Practice Address - Country:US
Practice Address - Phone:630-653-8464
Practice Address - Fax:630-653-8660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL200019Medicare ID - Type UnspecifiedIDTF