| Organization Name: | ATHLETIC IMAGING INC |
| NPI Number: | 1215269196 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RAJ KHANNA (MEDICAL DIRECTOR) |
| Mailing Address: | 2615 Harrison St Bellwood |
| State: | IL US |
| Postal Code: | 601042450 |
| Phone Number: | 7084930299 |
| Fax Number: | 7084930594 |
| NPI Enumeration Date: | 02/03/2010 |
| NPI Last Update Date: | 02/03/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Magnetic Resonance Imaging (MRI) |
| Taxonomy Definition: | |