EDGEBROOK RADIOLOGY MANAGEMENT (NPI# 1821045659) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821045659 |
| Entity Type | Organization |
| Organization Name | EDGEBROOK RADIOLOGY MANAGEMENT |
| Other Organization Name | EDGEBROOK RADIOLOGY |
| Practice Address |
5320 W Devon Ave Chicago IL 60646-4108 |
| Mailing Address |
Po Box 7389 Prospect Heights IL 60070-7389 |
| Practice Telephone | 7737746440 |
| Practice Fax Number | 7737744372 |
| Mailing Telephone | 8478703600 |
| Mailing Fax Number | 8478703500 |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2009-04-13 |
| Authorized Official Name | MR. GEORGE NELLAMATHATIL (DIRECTOR) |
| Authorized Official Telephone | 7737746440 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1200X |
Clinic/Center Specialization: Magnetic Resonance Imaging (MRI) |
IL | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| EDGEBROOK RADIOLOGY | Doing Business As Name - Organization |
| Street Address |
5320 W DEVON AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60646-4108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851649974 | Edgebrook Open Mri Inc | Clinic/Center | 5320 W Devon Ave, Chicago, IL 60646-4108 | 2012-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801312087 | Manal Ibrahim | Dentist | 6228 N Keystone Ave, Chicago, IL 60646 | 2017-08-18 |
| 1750820742 | Kaitlin O'brien | Student in an Organized Health Care Education/Training Program | 5801 N Pulaski, Chicago, IL 60646 | 2017-02-23 |
| 1659810646 | Sofia Trani | Student in an Organized Health Care Education/Training Program | 5801 N. Pulaski Rd, Chicago, IL 60646 | 2017-02-23 |
| 1487191151 | Ronald E. Rysztogi | Naprapath | 5704 N. Austin, Chicago, IL 60646 | 2017-01-19 |
| 1417403148 | Joyful Dental Care | Clinic/Center | 6314 N. Cicero Avenue, Chicago, IL 60646 | 2016-09-01 |
| 1164889754 | Physicians At Call | Family Medicine | 5901 N. Cicero Ave, Ste 207, Chicago, IL 60646 | 2016-01-27 |
| 1245610617 | Arlett Payne | Physician Assistant | 5906 N Milwaukee, Chicago, IL 60646 | 2015-06-01 |
| 1811375843 | North River Mental Health Center | Community/Behavioral Health | 5801 North Pulaski Road, Chicago, IL 60646 | 2015-05-11 |
| 1003157298 | Family Choice Home Health | Homemaker | 5933 N Milwaukee Avenue, Chicago, IL 60646 | 2013-03-13 |
| 1235479593 | Antonina Skapars Trinkuns | Psychiatry & Neurology | 6404 N. Tahoma Ave., Chicago, IL 60646 | 2013-02-25 |
| Find all providers in zip 60646 | ||||
| Taxonomy Code | 261QM1200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Magnetic Resonance Imaging (MRI) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326516584 | Loretto Hospital | Clinic/Center | 7431 S East End Ave, Floor 1st Suite 2, Chicago, IL 60649-3611 | 2018-11-06 |
| 1205379229 | Fulton Market Mri LLC | Clinic/Center | 559 W Kinzie St, Chicago, IL 60654-5702 | 2016-11-22 |
| 1922461664 | Smart Choice Mri, LLC | Clinic/Center | 1850 N Clybourn Ave, Chicago, IL 60614-8048 | 2016-03-31 |
| 1881954311 | Chicago Upright Mri, LLC | Clinic/Center | 22 N Morgan St, Unit 105, Chicago, IL 60607-2606 | 2012-05-17 |
| 1316949886 | Premier Health Services, Inc | Clinic/Center | 559 West Kinzie, Chicago, IL 60654 | 2005-08-13 |
| 1255732061 | Highpoint Open Mri of Chicago, LLC | Clinic/Center | 3855 N Cicero Ave, Chicago, IL 60641-3623 | 2014-09-11 |
| 1669881686 | Molecular Imaging Chicago LLC | Clinic/Center | 4351 N Cicero Ave, Chicago, IL 60641-1502 | 2014-08-04 |
| 1982014064 | Mayfair Advantage Mri, Inc | Clinic/Center | 4351 N Cicero Ave, Chicago, IL 60641-1502 | 2014-04-29 |
| 1881027860 | Illinois Imaging, Inc. | Clinic/Center | 4044 N Lincoln Ave, Suite 377, Chicago, IL 60618-3038 | 2013-08-14 |
| 1477886034 | Fullerton Mri LLC | Clinic/Center | 3405 W Fullerton Ave, Chicago, IL 60647-2415 | 2009-09-15 |
| Find all providers in CHICAGO | ||||
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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.