Individual provider Active NPI

Steven Andrew Archibald, M.D.

  • Diagnostic Radiology Physician
  • Chicago, IL
National Provider Identifier
1083657134
Registry record updated Jun 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036-104696 Issued in IL
Practice address
401 E. Ontario St.
#4601
Chicago, IL 60611-4444
Phone
(952) 595-1100
Fax
(612) 294-4903
NPI assigned
Jun 14, 2006
Last updated
Jun 24, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2015

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

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 036-104696 IL Primary
Diagnostic Radiology Physician 2085R0202X 35262 AZ
Diagnostic Radiology Physician 2085R0202X G87697 CA
Diagnostic Radiology Physician 2085R0202X M9531 ID
Diagnostic Radiology Physician 2085R0202X 01061626A IN
Diagnostic Radiology Physician 2085R0202X 4301087103 MI
Diagnostic Radiology Physician 2085R0202X 1167 MN
Diagnostic Radiology Physician 2085R0202X TM2006-0017 NM
Diagnostic Radiology Physician 2085R0202X 239553 NY
Diagnostic Radiology Physician 2085R0202X 2006-00472 NC
Diagnostic Radiology Physician 2085R0202X 25.000057 OH
Diagnostic Radiology Physician 2085R0202X MD428455 PA

Addresses

Primary practice location

401 E. Ontario St.
#4601
Chicago, IL 60611-4444

Mailing address

11995 Singletree LN
Suite 500
Eden Prairie, MN 55344-5347
Phone (952) 595-1301

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
239553NYMDLicensed Practical Nurse
1167MNMDNaturopath
35262AZMDDiagnostic Radiology Physician
G87697CAMDDiagnostic Radiology Physician
M9531IDMDDiagnostic Radiology Physician
036-104696ILMDDiagnostic Radiology Physician
01061626AINMDDiagnostic Radiology Physician
4301087103MIMDDiagnostic Radiology Physician
2006-00472NCMDDiagnostic Radiology Physician
TM2006-0017NMMDDiagnostic Radiology Physician
25.000057OHMDDiagnostic Radiology Physician
MD428455PAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Major Hospital Past Accepting new patients
Lafayette Radiology LLC Diagnostic Radiology Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435104000000",
    "number": "1083657134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11995 SINGLETREE LN",
            "address_2": "SUITE 500",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445347",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E. ONTARIO ST.",
            "address_2": "#4601",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114444",
            "telephone_number": "952-595-1100",
            "fax_number": "612-294-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHIBALD",
        "first_name": "STEVEN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2015-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036-104696",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "35262",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G87697",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ID",
            "license": "M9531",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01061626A",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301087103",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "1167",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NM",
            "license": "TM2006-0017",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "239553",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "2006-00472",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "25.000057",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD428455",
            "primary": false
        }
    ],
    "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 24, 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.

Verify at the official NPI Registry.