Provider Demographics
NPI:1992769277
Name:MOBILE IMAGING SOLUTIONS, INC.
Entity type:Organization
Organization Name:MOBILE IMAGING SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:RT (R)
Authorized Official - Phone:815-645-8985
Mailing Address - Street 1:149 HARVEST GLENN DR
Mailing Address - Street 2:
Mailing Address - City:DAVIS JUNCTION
Mailing Address - State:IL
Mailing Address - Zip Code:61020-9797
Mailing Address - Country:US
Mailing Address - Phone:815-645-8985
Mailing Address - Fax:815-645-8985
Practice Address - Street 1:149 HARVEST GLENN DR
Practice Address - Street 2:
Practice Address - City:DAVIS JUNCTION
Practice Address - State:IL
Practice Address - Zip Code:61020-9797
Practice Address - Country:US
Practice Address - Phone:815-645-8985
Practice Address - Fax:815-645-8985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL212848Medicare ID - Type Unspecified