Gregerson Radiology Consultants LTD.

Primary specialty

Radiology ChiropractorTaxonomy code 111NR0200X

License

038-005324 Issued in IL

Legal business name

GREGERSON RADIOLOGY CONSULTANTS LTD.

Practice address

8004 Red Fox Rd
Stanwood, MI 49346

Phone

(630) 854-3367

NPI assigned

May 16, 2007

Last updated

Aug 15, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Douglas M. Gregerson, D.A.C.B.R.

Title

Owner

Phone

(630) 854-3367

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565827200000",
    "number": "1114134681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8004 RED FOX RD",
            "city": "STANWOOD",
            "state": "MI",
            "postal_code": "493469641",
            "telephone_number": "630-854-3367",
            "fax_number": "630-578-1018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8004 RED FOX RD",
            "city": "STANWOOD",
            "state": "MI",
            "postal_code": "49346",
            "telephone_number": "630-854-3367"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "0S630 Preston Cir",
            "address_purpose": "LOCATION",
            "city": "Geneva",
            "state": "IL",
            "postal_code": "601346109",
            "country_code": "US",
            "telephone_number": "630-854-3367",
            "fax_number": "630-578-1018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GREGERSON RADIOLOGY CONSULTANTS LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2019-08-15",
        "status": "A",
        "authorized_official_last_name": "GREGERSON",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-854-3367",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.A.C.B.R."
    },
    "taxonomies": [
        {
            "code": "111NR0200X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Radiology",
            "state": "IL",
            "license": "038-005324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2019; 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.