Individual provider Active NPI

Louba Rodenko Laurie, MD

  • Diagnostic Radiology Physician
  • Belleville, IL
National Provider Identifier
1124067798
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036144971 Issued in IL
Practice address
4500 Memorial Dr
Dept Radiology
Belleville, IL 62226-5360
Phone
(618) 257-5613
Fax
(314) 454-4641
NPI assigned
Jun 6, 2006
Last updated
Sep 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X K0549 TX
Diagnostic Radiology Physician 2085R0202X 036144971 IL Primary

Addresses

Primary practice location

4500 Memorial Dr
Dept Radiology
Belleville, IL 62226-5360

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (618) 257-5613

Other practice location 1

2101 Pease St
Harlingen, TX 78550-8307
Phone (956) 389-6565

Other identifiers 1

IdentifierTypeStateIssuer
200051454MedicaidMO

Other names 1

  • Louba Rodenko Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, IL, IN, MO, FL5 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20031118000724 TX Practitioner - Diagnostic Radiology 4789598244 Reassigns benefits to 5 organizations
I20180322002002 IL Practitioner - Diagnostic Radiology 4789598244 Reassigns benefits to 1 organization
I20180829001970 IN Practitioner - Diagnostic Radiology 4789598244 Reassigns benefits to 1 organization
I20190417000725 MO Practitioner - Diagnostic Radiology 4789598244 Reassigns benefits to 3 organizations
I20251030005253 FL Practitioner - Diagnostic Radiology 4789598244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Texas Medical School at San Antonio, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Concord Radiology PLLCGroup PAC ID 8628332061, 217 clinicians
Clinical Radiologists SCGroup PAC ID 3476540873, 32 clinicians
Coaxion PLLCGroup PAC ID 3779099643, 31 clinicians
ER Physician Group at Jackson HospitalGroup PAC ID 8729059472, 153 clinicians

Practice addresses (Care Compare)

Dallas, TX 75225
Phone (888) 264-0330

100 Medical Dr
Hannibal, MO 63401-6877
Phone (573) 221-5250

1185 N 1000
Greene County General Hospital
Linton, IN 47441-5282
Phone (812) 847-5212

2040 W Iles Ave
Suite C
Springfield, IL 62704-4183
Phone (217) 726-8096

3050 Montvale Dr
Springfield, IL 62704-6924
Phone (217) 726-8096

3917 Purdue Ave
Dallas, TX 75225-7115
Phone (217) 726-8096

4250 Hospital Dr
Marianna, FL 32446-1917
Phone (850) 526-2200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036144971ILMDDiagnostic Radiology Physician
K0549TXMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Miracl, LLC CurrentSince Oct 22, 2025 Accepting new patients
Washington University Physicians in Illinois Inc Diagnostic Radiology CurrentSince Dec 15, 2025 Accepting new patients
ER Physician Group at Jackson Hospital CurrentSince Oct 21, 2025 Accepting new patients
Washington University Physicians in Illinois, Inc CurrentSince Dec 15, 2025 Accepting new patients
Concord Radiology PLLC Diagnostic Radiology CurrentSince Dec 31, 2025 Accepting new patients
Coaxion PLLC Diagnostic Radiology CurrentSince Dec 21, 2025 Accepting new patients
Crawford Hospital District Current Accepting new patients
Washington University Diagnostic Radiology CurrentSince Oct 22, 2025 Accepting new patients
Healthtexas Provider Network Past Accepting new patients
American Radiology Consultants PLLC Diagnostic Radiology Past Accepting new patients
Open MRI of Fort Worth, L.C. Past Accepting new patients
Lake Pointe Radiology Associates PA Diagnostic Radiology Past Accepting new patients
Singleton Associates PA Diagnostic Radiology Past Accepting new patients
American Health Imaging of Dallas LLC Past Accepting new patients
Ramic Fort Worth, LLC Past Accepting new patients
Lawrence County Memorial Hospital Past Accepting new patients
Taos Health Systems, Inc., Holy Cross Hospital Past Accepting new patients
Healthtexas-Med Provider Past Accepting new patients

Locations

4250 Hospital Dr
Marianna, FL 32446
Phone (850) 526-2200

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

4500 Memorial Dr
Belleville, IL 62226
Phone (618) 233-7750

2122 Troy Rd
Ste 130
Edwardsville, IL 62025
Phone (618) 692-9876

1000 N Allen St
Robinson, IL 62454
Phone (618) 544-3131

100 Medical Dr
Hannibal, MO 63401

1000 W 10th St
Rolla, MO 65401
Phone (573) 364-9000

510 S Kingshighway Blvd
Saint Louis, MO 63110
Phone (314) 362-0177

608 Avenue B
Ballinger, TX 76821
Phone (325) 365-2531

7502 Greenville Ave
Dallas, TX 75231
Phone (469) 221-6000

12930 East Fwy
Houston, TX 77015
Phone (281) 704-3836

215 Chisholm Trl
Jacksboro, TX 76458
Phone (940) 567-5528

575 Hill Country Dr
Ste 101
Kerrville, TX 78028
Phone (830) 258-7090

575 Hill Country Dr
Ste 202
Kerrville, TX 78028
Phone (830) 258-6237

1602 Avenue Q
Lubbock, TX 79401
Phone (469) 312-5137

8595 Medical Center Blvd
Port Arthur, TX 77640
Phone (409) 721-8600

Organizations & group practices 19

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 19

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1124067798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "618-257-5613",
            "fax_number": "314-454-4641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 MEMORIAL DR",
            "address_2": "DEPT RADIOLOGY",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265360",
            "telephone_number": "618-257-5613",
            "fax_number": "314-454-4641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2101 Pease St",
            "address_purpose": "LOCATION",
            "city": "Harlingen",
            "state": "TX",
            "postal_code": "785508307",
            "country_code": "US",
            "telephone_number": "956-389-6565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAURIE",
        "first_name": "LOUBA",
        "middle_name": "RODENKO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "K0549",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036144971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200051454",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "4500 Memorial Dr",
            "address_2": "Dept Radiology",
            "city": "Belleville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622265360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LOUBA",
            "last_name": "RODENKO",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Belleville, IL

Sources for this page

Verify at the official NPI Registry.