Provider Demographics
NPI:1770917288
Name:XCEL DIAGNOSTICS LLC
Entity type:Organization
Organization Name:XCEL DIAGNOSTICS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ETAI
Authorized Official - Middle Name:
Authorized Official - Last Name:SOOLIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-337-1000
Mailing Address - Street 1:8235 CHRISTIANA AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-2910
Mailing Address - Country:US
Mailing Address - Phone:224-337-1000
Mailing Address - Fax:224-337-0100
Practice Address - Street 1:8235 CHRISTIANA AVE
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-2910
Practice Address - Country:US
Practice Address - Phone:224-337-1801
Practice Address - Fax:224-331-0801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-03
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
293D00000X
IL04487494261QR0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
No293D00000XLaboratoriesPhysiological Laboratory