Evergreen Mobile Imaging, Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

EVERGREEN MOBILE IMAGING, INC

Practice address

799 Roosevelt Rd
BLDG#3 Suite#005
Glen Ellyn, IL 60137-5908

Phone

(630) 790-3644

Fax

(630) 790-3645

NPI assigned

Nov 15, 2006

Last updated

Sep 13, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Mohammed A Aleem

Title

President

Phone

(630) 790-3644

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221264000000",
    "number": "1104998806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "799 ROOSEVELT RD",
            "address_2": "BLDG#3 SUITE#005",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601375908",
            "telephone_number": "630-790-3644",
            "fax_number": "630-790-3645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "799 ROOSEVELT RD",
            "address_2": "BLDG#3 SUITE#005",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601375908",
            "telephone_number": "630-790-3644",
            "fax_number": "630-790-3645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN MOBILE IMAGING, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2008-09-13",
        "status": "A",
        "authorized_official_last_name": "ALEEM",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-790-3644",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Glen Ellyn, IL
• Providers in Glen Ellyn, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.