NPIMap

Organization Active NPI

Radiology Subspecialists of Northern Illinois, LLC

  • Diagnostic Radiology Physician
  • Geneva, IL
National Provider Identifier
1104378942
Registry record updated Oct 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
RADIOLOGY SUBSPECIALISTS OF NORTHERN ILLINOIS, LLC
Practice address
825 W State St
Suite 103E
Geneva, IL 60134-2080
Phone
(630) 208-4412
NPI assigned
Oct 27, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2016

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

Authorized official

Name
Diane Sarka
Title
Credentialing Specialist
Phone
(630) 928-5234

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary
Vascular & Interventional Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0204X

Addresses

Primary practice location

825 W State St
Suite 103E
Geneva, IL 60134-2080

Mailing address

825 W State St
Suite 103E
Geneva, IL 60134-2080
Phone (630) 208-4412

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170320000767 IL Part B Supplier - Clinic/Group Practice 2264717925 Receives reassigned benefits from 41 practitioners
Practice locations: Pittsfield, IL; Palos Park, IL; Palos Heights, IL; Oak Brook, IL; Naperville, IL; Lombard, IL; Inverness, IL; Sandwich, IL…

National Provider Directory

National Provider Directory

Locations

820 S Il Route 59
#100
Bartlett, IL 60103

235 S Gary Ave
#100
Bloomingdale, IL 60108

825 W State St
Ste 103E
Geneva, IL 60134

351 Delnor Dr
Geneva, IL 60134
Phone (630) 262-1001

300 Randall Rd
#100
Geneva, IL 60134

351 Delnor Dr
Ste 201B
Geneva, IL 60134

101 E 75th St
Naperville, IL 60565
Phone (630) 246-5258

636 Raymond Dr
Ste 106
Naperville, IL 60563
Phone (630) 416-2300

9500 Bryn Mawr Ave
Ste 300
Rosemont, IL 60018
Phone (847) 410-5706

4405 Weaver Pkwy
Warrenville, IL 60555
Phone (630) 352-5450

Practitioners & affiliated clinicians

Practitioners 41

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1477526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477526400000",
    "number": "1104378942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 W STATE ST",
            "address_2": "SUITE 103E",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601342080",
            "telephone_number": "630-208-4412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 W STATE ST",
            "address_2": "SUITE 103E",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601342080",
            "telephone_number": "630-208-4412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIOLOGY SUBSPECIALISTS OF NORTHERN ILLINOIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-27",
        "last_updated": "2016-10-27",
        "status": "A",
        "authorized_official_last_name": "SARKA",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "630-928-5234"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.