WAYNE MACOMB DIAGNOSTIC IMAGING CENTER INC


Address: 8690 Reliable, Chicago, IL 60686-0001
Phone: 5867756400

WAYNE MACOMB DIAGNOSTIC IMAGING CENTER INC (NPI# 1326042235) 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) 1326042235
Entity Type Organization
Organization Name WAYNE MACOMB DIAGNOSTIC IMAGING CENTER INC
Other Organization Name WAYNE MACOMB MRI CENTER
Practice Address 8690 Reliable
Chicago
IL 60686-0001
Mailing Address 18245 E 10 Mile Rd
Ste 100
Roseville
MI 48066-5807
Practice Telephone 5867756400
Practice Fax Number 5864981559
Mailing Telephone 5867756400
Mailing Fax Number 5864981559
Enumeration Date 2005-06-09
Last Update Date 2012-03-21
Authorized Official Name MRS. CAROLE ZUPAN (ADMINISTRATIVE DIRECTOR)
Authorized Official Telephone 5864352031
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2085R0202X Radiology
Specialization: Diagnostic Radiology
2085R0202X MI Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MI CAPE MEDICAL 000000005320 01
MI AETNA PPO 8331930 01
MI BLUE CARE NETWORK P42884 01
MI WELLNESS PLAN 1207380001 01
MI HEALTH ALLIANCE PLAN 70097B 01
MI BLUE CROSS 300E06144 01
MI CHAMPUS-TRICARE M015025 01
MI M CARE RA820051 01
MI AETNA HMO 0525947 01
MI PREFERRED CHOICES 104972 01
MI GREAT LAKES HEALTH PLAN 148899 01

Other Provider/Organization Names

Other Name Type Code
Wayne Macomb MRI Center Doing Business As Name - Organization

Office Location

Street Address 8690 RELIABLE
City CHICAGO
State IL
Zip Code 60686-0001

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1174765945 Mclaren Oakland Clinic/Center 8172 Reliable Pkwy, Chicago, IL 60686-0001 2009-03-25
1053566182 Kathryn A Davidson Counselor 2683 Reliable Pkwy, Chicago, IL 60686-0001 2008-11-17
1356590525 Keith A Roberts Optometrist 5855 Reliable Pkwy, Chicago, IL 60686-0001 2008-09-12
1194775858 Mandar A Pattekar Radiology 5200 Reliable Parkway, Chicago, IL 60686-0001 2006-05-11
1467447268 Mark B Austin Pathology 6810 Reliable Pkwy, Chicago, IL 60686-0001 2005-09-19
1235133141 Macomb Magnetic Resonance Imaging Center Inc Radiology 8956 Reliable Parkway, Chicago, IL 60686-0001 2005-06-09
1528019437 Craig A Fenton Radiology 5200 Reliable Parkway, Chicago, IL 60686-0001 2006-05-15
1578514543 Stephen M Smith Radiology 5200 Reliable Parkway, Chicago, IL 60686-0001 2006-05-15
1134170004 James A Mcgee Radiology 5200 Reliable Parkway, Chicago, IL 60686-0001 2006-05-15
1760433726 Carter S Young Radiology 5200 Reliable Parkway, Chicago, IL 60686-0001 2006-05-15
Find all providers in zip 60686

Taxonomy Information

Taxonomy Code 2085R0202X
Grouping Allopathic & Osteopathic Physicians
Classification Radiology
Specialization Diagnostic Radiology

Taxonomy Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1376196220 Parvathamma Imaging Services, LLC Radiology 7431 S East End Ave Ste 2, Chicago, IL 60649-3611 2019-07-19
1225516842 Tyler Jonathan Hinkel Radiology 33 W Ontario St Apt 46f, Chicago, IL 60654 2018-08-06
1366976631 Ali Mostafa Serhal Radiology 240 E. Huron St, Suite 1-203, Chicago, IL 60617 2017-04-13
1790132934 Peter Barton Moreau Radiology 1740 W Taylor St Rm 2483, Chicago, IL 60612-7232 2016-05-18
1043678899 Burce Ozgen Mocan Radiology 1740 W Taylor St Rm 2511, Department of Radiology (mc931), Chicago, IL 60612-7232 2016-02-08
1538552898 Imo Ime Uko Radiology 4646 N Marine Dr Ste 7100, Chicago, IL 60640 2015-03-11
1962891739 Katherine Conlon Radiology 240 E Huron St # 1-203, Chicago, IL 60611 2015-01-16
1861805871 Arun Nagaraju Radiology 5841 S. Maryland Ave. Suite Mc2026, University of Chicago, Chicago, IL 60637-1448 2014-06-06
1568873529 Emily Ghobadi Radiology 250 E Superior St Rm 4-2304, Chicago, IL 60611-2914 2014-05-13
1306266903 Jessica Kristen Peterson Radiology 250 E Superior St Ste 4-2304, Chicago, IL 60611-2914 2014-04-22
Find all providers in CHICAGO

Competitor

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City CHICAGO
Zip Code 60686

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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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