National Provider Identifier Database

PROVENA IMAGING SERVICES INC
Diagnostic Radiology

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.


Contact Information

PROVENA IMAGING SERVICES INC
100 PROVENA WAY
SUITE 104
BOURBONNAIS, IL60914
Phone: 815-929-5800
Fax: 815-929-5801
Website:
Specialty Taxonomy Code
* Diagnostic Radiology 2085R0202X

* Indicates primary specialty

NPI Profile & details for PROVENA IMAGING SERVICES INC

NPI Number 1720197601
Legal business name
LBN
PROVENA IMAGING SERVICES INC
Authorized official EDWARD MOLARE - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 08/30/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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