Midwest Diagnostic Management, LLC

NPI #1003933920 in Mokena, Illinois

Provider Information

NPI Number
1003933920
Entity Type
Organization
Organization Name
Midwest Diagnostic Management, LLC
Primary Specialty
Exclusive Provider Organization
Enumeration Date
Mar 24, 2007
Last Updated
Dec 10, 2008

Practice Location

Address
19065 HICKORY CREEK PL
Address 2
SUITE 240
City
Mokena
ZIP Code
60448-8507
Phone
(708) 478-6417

Authorized Official

Name
MR. JON KNIPPER
Title
CHIEF OPERATING OFFICER
Phone
(708) 478-6434

Specialties & Taxonomy Codes

Specialty
Exclusive Provider Organization

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