Portrait Health Centers Diagnostic Services | |
150 W Half Day Rd Suite 105 Buffalo Grove IL 60089-6591 | |
(847) 868-3435 | |
(847) 859-5885 |
Full Name | Portrait Health Centers Diagnostic Services |
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Speciality | Physiological Laboratory |
Location | 150 W Half Day Rd, Buffalo Grove, Illinois |
Authorized Official Name and Position | Jack A Maggiore (DIRECTOR) |
Authorized Official Contact | 8478683435 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Portrait Health Centers Diagnostic Services 150 W Half Day Rd Suite 105 Buffalo Grove IL 60089-6591 Ph: (847) 868-3435 | Portrait Health Centers Diagnostic Services 150 W Half Day Rd Suite 105 Buffalo Grove IL 60089-6591 Ph: (847) 868-3435 |
NPI Number | 1881975266 |
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Provider Enumeration Date | 08/30/2011 |
Last Update Date | 08/31/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1881975266 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TH0100X | Psychologist - Health Service | (* (Not Available)) | Secondary |
293D00000X | Physiological Laboratory | (* (Not Available)) | Primary |
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