Provider Demographics
NPI:1003654534
Name:1ST LOOK MOBILE ULTRASOUND LLC
Entity type:Organization
Organization Name:1ST LOOK MOBILE ULTRASOUND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / ULTRASOUND TECH
Authorized Official - Prefix:
Authorized Official - First Name:FELICITA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVARRP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-551-5783
Mailing Address - Street 1:501 N RIVERSIDE DR STE 217
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-5918
Mailing Address - Country:US
Mailing Address - Phone:224-551-5783
Mailing Address - Fax:224-532-2681
Practice Address - Street 1:501 N RIVERSIDE DR STE 217
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-5918
Practice Address - Country:US
Practice Address - Phone:224-551-5783
Practice Address - Fax:224-532-2681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology