Wood Dale Radiology LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

WOOD DALE RADIOLOGY LLC

Practice address

199 S Addison Rd Ste 107B
Wood Dale, IL 60191-1978

Phone

(630) 329-8030

NPI assigned

Feb 24, 2025

Organization subpart

No

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

Authorized official

Name

George Nellamattathil

Title

Director

Phone

(630) 329-8030

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1740355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744070400000",
    "number": "1063218535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7389",
            "city": "PROSPECT HEIGHTS",
            "state": "IL",
            "postal_code": "600707389",
            "telephone_number": "847-870-3600",
            "fax_number": "847-870-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 S ADDISON RD STE 107B",
            "city": "WOOD DALE",
            "state": "IL",
            "postal_code": "601911978",
            "telephone_number": "630-329-8030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOOD DALE RADIOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-24",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A",
        "authorized_official_last_name": "NELLAMATTATHIL",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "630-329-8030"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2025; 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.