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).
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 |
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 |
Street Address |
1890 SILVER CROSS BLVD STE 455 |
City | NEW LENOX |
State | IL |
Zip Code | 60451-9546 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871126227 | Forever Family Dental of New Lenox | Dentist | 202 Vancina Lane, New Lenox, IL 60451 | 2020-02-13 |
1699245662 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 115 East Maple St, New Lenox, IL 60451 | 2018-12-03 |
1093204778 | New Lenox Anesthesia LLC | Anesthesiology | 678 Cedar Crossing Dr, New Lenox, IL 60451 | 2018-05-08 |
1578068698 | My Medicar | Non-emergency Medical Transport (VAN) | 21625 S. Schoolhouse Rd, New Lenox, IL 60451 | 2018-03-29 |
1134646771 | Julianne M. Goudzwaard | Registered Nurse | 841 Buckboard Drive, New Lenox, IL 60451 | 2017-08-24 |
1063947422 | Silver Cross Ambulatory Surgery Center, LLC | Clinic/Center | 1003 Pawlak Parkway, New Lenox, IL 60451 | 2017-04-24 |
1386090041 | Lindsey Reimer | Speech-Language Pathologist | 3515 Golf Ave, New Lenox, IL 60451 | 2016-05-11 |
1295105484 | Alison Elaine Burchardt | Nurse Practitioner | 1890 Silver Cross Boulevard, Pavilion A, Suite 240, New Lenox, IL 60451 | 2015-09-30 |
1700278959 | Dental Professionals of Illinois, P.c | Dentist | 561 E Lincoln Hwy, New Lenox, IL 60451 | 2015-02-25 |
1912319146 | Teresea Bargewell | Counselor | 1049 E. Lincoln Hwy, Decision Point Counseling and Career Center, New Lenox, IL 60451 | 2014-05-22 |
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Taxonomy Code | 261QR0200X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Radiology |
Definition to come... |
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1063960276 | Mars Healthcare LLC | Clinic/Center | 721 W Highway 22nd, Lake Zurich, IL 60047 | 2016-09-16 |
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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.