NPIMap

Organization Active NPI

Advanced Midwest Radiology S C

  • Diagnostic Radiology Physician
  • New Lenox, IL
National Provider Identifier
1013965326
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
042000995 Issued in IL
Legal business name
ADVANCED MIDWEST RADIOLOGY S C
Practice address
1900 Silver Cross Blvd
New Lenox, IL 60451
Phone
(815) 717-8478
Fax
(815) 717-8794
NPI assigned
May 5, 2006
Last updated
Dec 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Authorized official

Name
Sylvia Stone
Title
Business Manager
Phone
(630) 581-6504

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 042000995 IL Primary

Addresses

Primary practice location

1900 Silver Cross Blvd
New Lenox, IL 60451

Mailing address

1200 Harger Rd Ste 408
Oak Brook, IL 60523-1818
Phone (630) 581-6504

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MT, WY3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040813001116 IL Part B Supplier - Clinic/Group Practice 0941273320 Receives reassigned benefits from 26 practitioners
Practice locations: Chicago, IL; Homer Glen, IL; New Lenox, IL; Orland Park, IL
O20230131003112 MT Part B Supplier - Clinic/Group Practice 0941273320 Receives reassigned benefits from 1 practitioner
Practice locations: Kalispell, MT
O20240116002257 WY Part B Supplier - Clinic/Group Practice 0941273320 Receives reassigned benefits from 1 practitioner
Practice locations: Pinedale, WY

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

6801 W 73rd St
Unit 637
Bedford Park, IL 60499

39069 Treasury Ctr
Chicago, IL 60694

701 E Orange St
#H
Hoopeston, IL 60942
Phone (217) 283-5531

1200 Harger Rd
Ste 408
Oak Brook, IL 60523
Phone (630) 581-6538

7425 Janes Ave
Ste 205
Woodridge, IL 60517
Phone (217) 850-1133

Practitioners & affiliated clinicians

Practitioners 44

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702944000000",
    "number": "1013965326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 HARGER RD STE 408",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231818",
            "telephone_number": "630-581-6504",
            "fax_number": "630-645-6407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SILVER CROSS BLVD",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "60451",
            "telephone_number": "815-717-8478",
            "fax_number": "815-717-8794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED MIDWEST RADIOLOGY S C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A",
        "authorized_official_last_name": "STONE",
        "authorized_official_first_name": "SYLVIA",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "630-581-6504"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "042000995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Lenox, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.