MEDIVERSE PROFESSIONAL GROUP PLLC NPI 1356275630

NPI Information

  • NPI: 1356275630
  • Provider Name: MEDIVERSE PROFESSIONAL GROUP PLLC
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Organization
  • CLIA Number: 14D2330537
  • Address: 2210 MIDWEST RD STE 105
    OAK BROOK, IL
    ZIP 60523
  • Phone: (630) 440-7786

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NPI Details

MEDIVERSE PROFESSIONAL GROUP PLLC is a diagnostic radiology radiology in Oak Brook, IL. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. MEDIVERSE PROFESSIONAL GROUP PLLC NPI is 1356275630. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2210 MIDWEST RD STE 105
OAK BROOK, IL
ZIP 60523-206
Phone: (630) 440-7786
Fax: (312) 807-3550

The provider's authorized official is Usman K Qadeer .
The authorized official title is Authorized Official and has the following contact phone number (607) 738-0240.

The CLIA number assigned to this NPI record is 14D2330537 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/11/2026 and was last updated on 6/11/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0202XRadiologyDiagnostic RadiologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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