| Organization Name: | MEDPRO IMAGING MOBILE SERVICES, LLC |
| NPI Number: | 1205166915 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBIN SUE HOFFMAN (PRESIDEND/CEO) |
| Mailing Address: | 472 Briargate Dr 107 South Elgin |
| State: | IL US |
| Postal Code: | 601772225 |
| Phone Number: | 6304250088 |
| Fax Number: | |
| NPI Enumeration Date: | 12/30/2009 |
| NPI Last Update Date: | 10/06/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2471S1302X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Radiologic Technologist |
| Taxonomy Specialization: | Sonography |
| Taxonomy Definition: | |