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Contact Information

PHC OF BUFFALO GROVE DIAGNOSTIC SERVICES
150 W HALF DAY RD
SUITE 105
BUFFALO GROVE, IL60089-6591
 Phone: 847-868-3435
 Fax: 847-859-5885
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physiological Laboratory, (Independent Physiological Lab)

293D00000X 47 Independent Diagnostic Testing Facility (IDTF)
 

Health Service

103TH0100X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for PHC OF BUFFALO GROVE DIAGNOSTIC SERVICES

NPI Number 1881975266
LBN Legal business name PHC OF BUFFALO GROVE DIAGNOSTIC SERVICES
Authorized official JACK MAGGIORE - (DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 08/30/2011
Last updated 08/31/2011 - About 15 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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