NPIMap

Organization Active NPI

Molecular Imaging of Bolingbrook, LLC

  • Radiology Clinic/Center
  • Bolingbrook, IL
National Provider Identifier
1023294733
Registry record updated Jan 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
MOLECULAR IMAGING OF BOLINGBROOK, LLC
Practice address
215 Remington Blvd
Bolingbrook, IL 60440-3656
Phone
(630) 325-6300
Fax
(630) 325-6390
NPI assigned
Jan 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2008

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

Authorized official

Name
Mrs. Alice Michelle Gardner
Title
Director of Facility Operations
Phone
(630) 325-6300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary

Addresses

Primary practice location

215 Remington Blvd
Bolingbrook, IL 60440-3656

Mailing address

215 Remington Blvd
Bolingbrook, IL 60440-3656
Phone (630) 325-6300

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200009600000",
    "number": "1023294733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604403656",
            "telephone_number": "630-325-6300",
            "fax_number": "630-325-6390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604403656",
            "telephone_number": "630-325-6300",
            "fax_number": "630-325-6390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOLECULAR IMAGING OF BOLINGBROOK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-11",
        "last_updated": "2008-01-11",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "ALICE",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "DIRECTOR OF FACILITY OPERATIONS",
        "authorized_official_telephone_number": "630-325-6300",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolingbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2008; 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.