Img MD, LLC

Primary specialty

Ph.D. Medical GeneticsTaxonomy code 170100000X

Legal business name

IMG MD, LLC

Practice address

680 N Lake Shore Dr
Chicago, IL 60611-4546

Phone

(312) 981-4400

NPI assigned

Nov 11, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Tracy Rady

Title

Billing Specialist

Phone

(847) 809-7381

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1384128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384128000000",
    "number": "1003245085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114546",
            "telephone_number": "312-981-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMG MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-11",
        "last_updated": "2013-11-11",
        "status": "A",
        "authorized_official_last_name": "RADY",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "BILLING SPECIALIST",
        "authorized_official_telephone_number": "847-809-7381",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "170100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Medical Genetics, Ph.D. Medical Genetics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ph.D. Medical Genetics in Chicago, IL
• Providers in Chicago, IL by specialty
• Ph.D. Medical Genetics in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.