Provider Demographics
NPI:1417216912
Name:MILWAUKEE IMAGING, INC.
Entity type:Organization
Organization Name:MILWAUKEE IMAGING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-675-5292
Mailing Address - Street 1:251 MILWAUKEE AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-2809
Mailing Address - Country:US
Mailing Address - Phone:847-675-5292
Mailing Address - Fax:
Practice Address - Street 1:251 MILWAUKEE AVE
Practice Address - Street 2:1015
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-2809
Practice Address - Country:US
Practice Address - Phone:847-675-5292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-04
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Multi-Specialty