Illinois Valley Radiology

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

ILLINOIS VALLEY RADIOLOGY

Practice address

111 Spring St
Streator, IL 61364-3332

Phone

(815) 673-2311

NPI assigned

Jul 15, 2005

Last updated

Apr 20, 2008By 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

Mark Hilborn, MD

Title

President

Phone

(815) 673-2311

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1124027826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4234 N BRANDYWINE DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145566",
            "telephone_number": "866-286-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 SPRING ST",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "613643332",
            "telephone_number": "815-673-2311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS VALLEY RADIOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-15",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "HILBORN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-673-2311",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "05023282",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Diagnostic Radiology Physician in Streator, IL
• Providers in Streator, IL by specialty
• Diagnostic Radiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.