Presence Ambulatory Services

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

PRESENCE AMBULATORY SERVICES

Doing business as

PRESENCE ADVANCED IMAGING CENTER

Practice address

205 S Northwest Hwy
Suite 120
Park Ridge, IL 60068-5802

Phone

(847) 292-5200

Fax

(847) 292-5239

NPI assigned

Apr 27, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Melvonne Wickliffe-Jones

Title

Credentialing MGR

Phone

(630) 914-2417

Specialties & licenses 1

Addresses

Other names 1

• PRESENCE ADVANCED IMAGING CENTER Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Presence Chicago Hospitals Network

  • Psychiatric Hospital Unit
  • Chicago, IL
  • NPI 1194404251

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1335484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369785600000",
    "number": "1164780144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 REMINGTON BLVD",
            "address_2": "SUITE 100",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604400000",
            "telephone_number": "630-914-2417",
            "fax_number": "630-914-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S NORTHWEST HWY",
            "address_2": "SUITE 120",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600685802",
            "telephone_number": "847-292-5200",
            "fax_number": "847-292-5239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESENCE AMBULATORY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-27",
        "last_updated": "2013-05-29",
        "status": "A",
        "authorized_official_last_name": "WICKLIFFE-JONES",
        "authorized_official_first_name": "MELVONNE",
        "authorized_official_title_or_position": "CREDENTIALING MGR",
        "authorized_official_telephone_number": "630-914-2417",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRESENCE ADVANCED IMAGING CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Premier Wellcare, Inc.
• Premier Wellness Care Inc.
• Premiere Anesthesia Group LLC
• Lauren K Prescott
• Presence Ambulatory Services
• Presence Healthcare Services
• Presence Healthcare Services
• Presence Senior Services Chicagoland
• Daniel Joshua Press, O.D.
• Prestige Clinical Laboratory LLC

• Radiology Clinic/Center in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Radiology Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2013; 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.