NPI 1003063421

Professional Diagnostic Service, S.C.

Organisation Community/Behavioral Health Agency Chicago, IL

Practice location

Address: 821 W van Buren St, Chicago, IL 60607-3517
Phone: (312) 491-0404
Fax: (312) 491-0505

Authorised official

Name: Kenneth Davis
Title: President
Phone: (312) 491-0404

Registered specialties

Community/Behavioral Health Agency Primary

Agencies Taxonomy 251S00000X Licence A-3920-0003-A (IL)

Other Community/Behavioral Health providers in Illinois →

Registry record

NPI: 1003063421
Entity type: Organization
NPI issued: 27 Aug 2008
Record last updated: 27 Aug 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.