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A supplier that provides one or more of the following portable services, including but not limited to, x-ray, electrocardiogram (EKG), long-term EKG (Holter Monitor), bone densitometry, sonography, and other imaging services in accordance with all state and federal requirements, under the general supervision of a qualified physician. All necessary resources are transported to the patient's location where the services are performed.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Portable Xray Supplier |
335V00000X | 63 | Portable X-Ray Supplier |
| NPI Number | 1467590471 |
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| LBN Legal business name | SUBURBAN XRAY | ||||||||
| Authorized official | PAMELA BALLARD - (PRESIDENT) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | No | ||||||||
| Enumeration date | 02/02/2007 | ||||||||
| Last updated | 08/22/2020 - About 6 years ago | ||||||||
| Identifiers |
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SUBURBAN XRAY
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| LINDA JENIG 230 THOMAS DRIVE 10000 DALE, IL |
| VICTORIA R GREENLEE, MOT 719 N MARION STREET 60302, IL |
SUBURBAN XRAY