NPIMap

Organization Active NPI

Midlick's Medical Imaging Inc.

  • Diagnostic Ultrasound Physician
  • Woodridge, IL
National Provider Identifier
1023178068
Registry record updated Jan 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Ultrasound PhysicianTaxonomy code 2085U0001X
Legal business name
MIDLICK'S MEDICAL IMAGING INC.
Practice address
6686 Double Eagle Dr
Unit 103
Woodridge, IL 60517-5428
Phone
(630) 663-9811
Fax
(630) 663-9018
NPI assigned
Dec 11, 2006
Last updated
Jan 11, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2017

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

Authorized official

Name
David George MidlickNPI 1477673275
Title
President Owner
Phone
(630) 663-9811

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Ultrasound Physician 2085U0001X Primary

Addresses

Primary practice location

6686 Double Eagle Dr
Unit 103
Woodridge, IL 60517-5428

Mailing address

6686 Double Eagle Dr
Unit 103
Woodridge, IL 60517-5428
Phone (630) 663-9811

Other identifiers 2

IdentifierTypeStateIssuer
02230032OtherILBLUE CROSS BLUE SHIELD
02230031OtherILBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

8743 W Odgen Ave
Lyons, IL 60534

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484092800000",
    "number": "1023178068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6686 DOUBLE EAGLE DR",
            "address_2": "UNIT 103",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605175428",
            "telephone_number": "630-663-9811",
            "fax_number": "630-663-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6686 DOUBLE EAGLE DR",
            "address_2": "UNIT 103",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605175428",
            "telephone_number": "630-663-9811",
            "fax_number": "630-663-9018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDLICK'S MEDICAL IMAGING INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2017-01-11",
        "status": "A",
        "authorized_official_last_name": "MIDLICK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "PRESIDENT  OWNER",
        "authorized_official_telephone_number": "630-663-9811"
    },
    "taxonomies": [
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "02230032",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "02230031",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2017; 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.