Steven Andrew Archibald, M.D.

Individual provider Active NPI Diagnostic Radiology Physician · Chicago, IL

NPI 1083657134 · NPPES record last updated Jun 24, 2015

Key facts

NPI
1083657134
Entity type
Individual (NPI type 1)
Primary specialty
Diagnostic Radiology Physician 2085R0202X
License
036-104696 (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
Sex
Male
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1167MNMDRegistered Dietitian
239553NYMDLicensed Practical Nurse
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 036-104696 IL Yes
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

Other providers in Chicago, IL

All providers in Chicago, IL · Diagnostic Radiology Physician in Illinois

Sources for this page

Verify at the official NPI Registry.