ADVANCED MIDWEST INTERVENTIONAL RADIOLOGY, LLC


Address: 1890 Silver Cross Blvd Ste 455, New Lenox, IL 60451-9546
Phone: 8159009060

ADVANCED MIDWEST INTERVENTIONAL RADIOLOGY, LLC (NPI# 1114438769) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1114438769
Entity Type Organization
Organization Name ADVANCED MIDWEST INTERVENTIONAL RADIOLOGY, LLC
Practice Address 1890 Silver Cross Blvd Ste 455
New Lenox
IL 60451-9546
Mailing Address 1200 Harger Rd Ste 408
Oak Brook
IL 60523-1818
Practice Telephone 8159009060
Mailing Telephone 6305816524
Enumeration Date 2017-10-21
Last Update Date 2017-10-21
Authorized Official Name DR. KUNTAL RANA (MANAGER)
Authorized Official Telephone 8159009060
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 2085R0204X Radiology
Specialization: Vascular & Interventional Radiology
Allopathic & Osteopathic Physicians
Y 261QR0200X Clinic/Center
Specialization: Radiology
Ambulatory Health Care Facilities

Office Location

Street Address 1890 SILVER CROSS BLVD STE 455
City NEW LENOX
State IL
Zip Code 60451-9546

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Taxonomy Information

Taxonomy Code 261QR0200X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Radiology

Taxonomy Definition

Definition to come...

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Competitor

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City NEW LENOX
Zip Code 60451

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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