NORTHSHORE REGIONAL PET SCAN, LLC (NPI# 1710988423) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710988423 |
| Entity Type | Organization |
| Organization Name | NORTHSHORE REGIONAL PET SCAN, LLC |
| Practice Address |
1464 Waukegan Rd Glenview IL 60025-2121 |
| Mailing Address |
3733 Park East Dr Suite 100 Beachwood OH 44122-4338 |
| Practice Telephone | 8479200500 |
| Mailing Telephone | 2162929998 |
| Mailing Fax Number | 2162929799 |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2008-02-06 |
| Authorized Official Name | MRS. NANCY WESTRICH (MANAGING PARTNER) |
| Authorized Official Telephone | 2162929998 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085N0904X |
Radiology Specialization: Nuclear Radiology |
Allopathic & Osteopathic Physicians |
| Street Address |
1464 WAUKEGAN RD |
| City | GLENVIEW |
| State | IL |
| Zip Code | 60025-2121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790287118 | Nl Speech and Language Path LLC | Speech-Language Pathologist | 1315 Sherwood Rd., Glenview, IL 60025 | 2018-03-01 |
| 1982128021 | Quinn Goodwin | Speech-Language Pathologist | 41 Waukegan Rd., Glenview, IL 60025 | 2017-07-31 |
| 1447773684 | Roshni Jaimon | Nurse Practitioner | 616 Meadow Dr, Glenview, IL 60025 | 2017-07-19 |
| 1053840488 | Progressive Behavior Solutions LLC | Behavioral Analyst | 2519 Allison Court, Glenview, IL 60025 | 2017-06-08 |
| 1720529969 | Catherine Marquard | Social Worker | 1949 Robincrest Ln, Glenview, IL 60025 | 2017-03-20 |
| 1073055398 | Imad Dababneh | Optometrist | 4150 Williamsburg Ct. Apt 101, Glenview, IL 60025 | 2016-11-17 |
| 1417400565 | Megan Bowman | Nutritionist | 1332 Waukegan Rd., Glenview, IL 60025 | 2016-07-25 |
| 1548621402 | Integrated Care Servises Corp | In Home Supportive Care | 4001 Amalfi Dr., Glenview, IL 60025 | 2016-03-18 |
| 1003277237 | Caring Nurses, Inc | Home Health | 1701 East Lake Ave, Suite 360, Glenview, IL 60025 | 2016-03-16 |
| 1033570841 | Sumy Johny | Pharmacist | 25 Waukegan Road, Glenview, IL 60025 | 2016-03-08 |
| Find all providers in zip 60025 | ||||
| Taxonomy Code | 2085N0904X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Nuclear Radiology |
| A radiologist who is involved in the analysis and imaging of radionuclides and radiolabeled substances in vitro and in vivo for diagnosis and the administration of radionuclides and radiolabeled substances for the treatment of 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114420304 | Khushboo Gupta | Radiology | Rumc, 1653 W Congress Pkwy, Jelke 181, Department of Radiology and Nuclear Medicine, Chicao, IL 60612 | 2018-03-14 |
| 1427272418 | Highland Nuclear Imaging LLP | Radiology | 330 W Army Trail Rd, Suite 405, Bloomingdale, IL 60108-2681 | 2007-04-12 |
| 1437231560 | Future Diagnostics Group LLC | Radiology | 254 Republic Ave, Joliet, IL 60435-6518 | 2006-10-19 |
| 1356310163 | Northwest Suburban Imaging Associates, S.c. | Radiology | 1425 N Randall Rd, Elgin, IL 60123-2300 | 2006-03-15 |
| 1093716722 | Hinsdale Regional Pet Scan, LLC | Radiology | 812 E Ogden Ave, Westmont, IL 60559-1246 | 2005-08-03 |
| 1396744751 | Northern Illinois Diagnostic Medical Imaging | Radiology | 200 Berteau Ave, Elmhurst, IL 60126-2966 | 2005-07-19 |
| 1306131719 | Cardiac Imaging Sc | Radiology | 1440 W North Ave, Suite 101, Melrose Park, IL 60160-1422 | 2011-06-14 |
| 1023240470 | John C Tricou Md LLC | Radiology | 200 E Fairman Ave, Watseka, IL 60970-1644 | 2009-08-19 |
| 1902030661 | Joliet Oncology Hematology Associates Ltd | Radiology | 3825 Highland Ave, # 2l,tower 1, Downers Grove, IL 60515-1552 | 2009-05-11 |
| 1760621833 | Joliet Oncology Hematology Associates Ltd | Radiology | 500 Remington Blvd, Bolingbrook, IL 60440-4906 | 2009-02-13 |
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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.