Organization Active NPI

Elmhurst Radiologists, SC

  • Diagnostic Radiology Physician
  • Elmhurst, IL
National Provider Identifier
1023021524
Registry record updated Nov 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
ELMHURST RADIOLOGISTS, SC
Practice address
200 N Berteau Ave
Elmhurst, IL 60126-2966
Phone
(630) 833-1400
NPI assigned
Aug 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2007

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

Authorized official

Name
Jerold Weinberg, MD
Title
President
Phone
(630) 833-1400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

200 N Berteau Ave
Elmhurst, IL 60126-2966

Mailing address

200 N Berteau Ave
Elmhurst, IL 60126-2966
Phone (630) 833-1400

Other identifiers 1

IdentifierTypeStateIssuer
CM3874OtherILPALMETTO GBA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040519001175 IL Part B Supplier - Clinic/Group Practice 3375534316 Receives reassigned benefits from 26 practitioners
Practice locations: Addison, IL; Deerfield, IL; Elmhurst, IL; Highland Park, IL; Hinsdale, IL; Lombard, IL; Oak Park, IL

National Provider Directory

National Provider Directory

Locations

172 E Schiller St
Elmhurst, IL 60126
Phone (331) 221-6377

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194912000000",
    "number": "1023021524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N BERTEAU AVE",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262966",
            "telephone_number": "630-833-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N BERTEAU AVE",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262966",
            "telephone_number": "630-833-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELMHURST RADIOLOGISTS, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-11-13",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "JEROLD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-833-1400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "CM3874",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2007; 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.