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EDGEBROOK RADIOLOGY MANAGEMENT NPI 1821045659


NPI Information

NPI: 1821045659
Provider Name: EDGEBROOK RADIOLOGY MANAGEMENT

Doing Business As: EDGEBROOK RADIOLOGY

Classification: Clinic/Center - 261QM1200X
Entity Type: Organization

Specialization: Magnetic Resonance Imaging (MRI)

Address:
5320 W DEVON AVE
CHICAGO, IL
ZIP 60646
Phone: (773) 774-6440
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EDGEBROOK RADIOLOGY MANAGEMENT is a magnetic resonance imaging (mri) clinic center in Chicago, IL. EDGEBROOK RADIOLOGY MANAGEMENT NPI is 1821045659. The provider is registered as an organization entity type.
The provider Is Doing Business As Edgebrook Radiology.

The provider's business location address is:

5320 W DEVON AVE
CHICAGO, IL
ZIP 60646-108
Phone: (773) 774-6440
Fax: (773) 774-4372

The provider's authorized official is George Nellamathatil .
The authorized official title is Director and has the following contact phone number (773) 774-6440.

The enumeration date for this NPI number is 5/27/2006 and was last updated on 4/13/2009.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM1200XClinic/CenterMagnetic Resonance Imaging (MRI)ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1701780MEDICARE ID-TYPE UNSPECIFIEDILLINOIS

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: 11/14/2023

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