1174839575 NPI number — DAWN DIAGNOSTICS IMAGING GROUP INC.

Table of content: DR. CHARLOTTE MORRIGAN BROWN M.D. (NPI 1083857957)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174839575 NPI number — DAWN DIAGNOSTICS IMAGING GROUP INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DAWN DIAGNOSTICS IMAGING GROUP INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174839575
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/16/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8023 KILPATRICK AVE APT 1A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SKOKIE
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60076-3055
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-840-6761
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8023 KILPATRICK AVE APT 1A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SKOKIE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60076-3055
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-840-6761
Provider Business Practice Location Address Fax Number:
844-364-6372
Provider Enumeration Date:
08/23/2010

Additional Information

Authorized Official

Authorized Official Last Name:
AWAN
Authorized Official First Name:
IMTIAZ
Authorized Official Middle Name:
H
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
847-840-6761

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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