| Organization Name: | CHICAGO RIDGE RADIOLOGY SC |
| NPI Number: | 1538497920 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ABDUL AMINE (VICE PRESIDENT) |
| Mailing Address: | 9830 Ridgeland Ave Ste 8 Chicago Ridge |
| State: | IL US |
| Postal Code: | 604152667 |
| Phone Number: | 7084231819 |
| Fax Number: | 7084234788 |
| NPI Enumeration Date: | 11/24/2009 |
| NPI Last Update Date: | 03/17/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Multi-Specialty |
| Taxonomy Definition: | |