Organization Active NPI

Souma Diagnostics, LTD

  • Diagnostic Ultrasound Physician
  • Chicago, IL
National Provider Identifier
1104953017
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Ultrasound PhysicianTaxonomy code 2085U0001X
Legal business name
SOUMA DIAGNOSTICS, LTD
Practice address
680 N Lake Shore Dr
Suite 1429
Chicago, IL 60611-4546
Phone
(312) 654-9100
Fax
(312) 654-9202
NPI assigned
Feb 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Rudy E Sabbagh, MD,FACOG
Title
Medical Director
Phone
(312) 654-9100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Ultrasound PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085U0001X IL Primary

Addresses

Primary practice location

680 N Lake Shore Dr
Suite 1429
Chicago, IL 60611-4546

Mailing address

PO Box 11690
Chicago, IL 60611-0690
Phone (773) 735-2110

National Provider Directory

National Provider Directory

Locations

680 N Lake Shore Dr
Ste 1429
Chicago, IL 60611
Phone (312) 654-9100

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104953017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11690",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606110690",
            "telephone_number": "773-735-2110",
            "fax_number": "773-735-4238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR",
            "address_2": "SUITE 1429",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114546",
            "telephone_number": "312-654-9100",
            "fax_number": "312-654-9202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUMA DIAGNOSTICS, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SABBAGH",
        "authorized_official_first_name": "RUDY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "312-654-9100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD,FACOG"
    },
    "taxonomies": [
        {
            "code": "2085U0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "IL",
            "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 Aug 22, 2020; 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.