Organization · Type 2 NPI

Provena Imaging Services Inc

Diagnostic Radiology Physician · Bourbonnais, IL

NPI number 1720197601 Active

Practice location

100 Provena Way, Suite 104
Bourbonnais, IL 60914

Call (815) 929-5800 Map

Fax (815) 929-5801

Mailing address

5775 Wayzata Blvd, Suite 400
St. Louis Park, MN 55416

Specialties and licenses

TaxonomyCodeLicense
Diagnostic Radiology Physician Primary 2085R0202XNone listed

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

6 other providers at this address

About NPI 1720197601

Provena Imaging Services Inc's National Provider Identifier is 1720197601, issued on Aug 30, 2006. The primary taxonomy on file is Diagnostic Radiology Physician (2085R0202X), and the practice location is in Bourbonnais, IL. The record was last updated on Aug 22, 2020.