Active NPI
Richard Felicelda
- Vascular Sonography Radiologic Technologist
- Chicago, IL
National Provider Identifier
1083095293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Sonography Radiologic Technologist
- Practice address
- 3510 W 79TH St
Suite 4
Chicago, IL 60652-1430 - Phone
- (847) 329-7500
- Fax
- (847) 807-4403
- NPI assigned
- Jun 12, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Specialist/Technologist Cardiovascular | 246XC2903X | |||
| Radiologic Technologist | 247100000X | |||
| Cardiovascular-Interventional Technology Radiologic Technologist | 2471C1101X | |||
| Radiography Radiologic Technologist | 2471C3402X | |||
| Vascular Sonography Radiologic Technologist | 2471V0105X | Primary |
Addresses
Primary practice location
3510 W 79TH St
Suite 4
Chicago, IL 60652-1430
Mailing address
3510 W 79TH St
Suite 4
Chicago, IL 60652-1430
Phone (847) 329-7500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434067200000",
"number": "1083095293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3510 W 79TH ST",
"address_2": "SUITE 4",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606521430",
"telephone_number": "847-329-7500",
"fax_number": "847-807-4403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3510 W 79TH ST",
"address_2": "SUITE 4",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606521430",
"telephone_number": "847-329-7500",
"fax_number": "847-807-4403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FELICELDA",
"first_name": "RICHARD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-12",
"last_updated": "2015-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "246XC2903X",
"taxonomy_group": "",
"desc": "Specialist/Technologist Cardiovascular, Vascular Specialist",
"state": null,
"license": null,
"primary": false
},
{
"code": "247100000X",
"taxonomy_group": "",
"desc": "Radiologic Technologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "2471C1101X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Cardiovascular-Interventional Technology",
"state": null,
"license": null,
"primary": false
},
{
"code": "2471C3402X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Radiography",
"state": null,
"license": null,
"primary": false
},
{
"code": "2471V0105X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Vascular Sonography",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.