Provider Demographics
NPI:1023406477
Name:PHYSICIAN IMAGING SOLUTIONS INC
Entity type:Organization
Organization Name:PHYSICIAN IMAGING SOLUTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:DYBCIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-362-2707
Mailing Address - Street 1:9001 DARIEN WOODS CT
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:IL
Mailing Address - Zip Code:60561-5286
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:24012 W LOCKPORT ST
Practice Address - Street 2:SUITE 2E
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-2280
Practice Address - Country:US
Practice Address - Phone:708-362-2707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-07
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory