Provider Demographics
NPI:1811097918
Name:HIGH-TECH IMAGING, INC.
Entity type:Organization
Organization Name:HIGH-TECH IMAGING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:STARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:RDMS, RDCS, RVT, RT
Authorized Official - Phone:708-442-9292
Mailing Address - Street 1:405 SHAWMUT AVE STE 209
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:IL
Mailing Address - Zip Code:60526-2000
Mailing Address - Country:US
Mailing Address - Phone:708-442-9292
Mailing Address - Fax:708-442-0808
Practice Address - Street 1:405 SHAWMUT AVE STE 209
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:IL
Practice Address - Zip Code:60526-2000
Practice Address - Country:US
Practice Address - Phone:708-442-9292
Practice Address - Fax:708-442-0808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonographyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1619039OtherBCBS
IL=========001Medicaid
IL1619039OtherBCBS