Active NPI
Pearl Mawst
- Radiologic Technologist
- Olympia Fields, IL
National Provider Identifier
1164878328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiologic Technologist
- License
- 372969
- Practice address
- 3212 Vollmer Rd Ste a
Olympia Fields, IL 60461-1122 - Phone
- (708) 481-9800
- Fax
- (708) 481-9808
- NPI assigned
- May 6, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiologic Technologist | 247100000X | 372969 | IL | Primary |
Addresses
Primary practice location
3212 Vollmer Rd Ste a
Olympia Fields, IL 60461-1122
Mailing address
3212 Vollmer Rd Ste a
Olympia Fields, IL 60461-1122
Phone (708) 481-9800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 372969 | IL | MD | Radiologic Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462492800000",
"number": "1164878328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3212 VOLLMER RD STE A",
"city": "OLYMPIA FIELDS",
"state": "IL",
"postal_code": "604611122",
"telephone_number": "708-481-9800",
"fax_number": "708-481-9808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3212 VOLLMER RD STE A",
"city": "OLYMPIA FIELDS",
"state": "IL",
"postal_code": "604611122",
"telephone_number": "708-481-9800",
"fax_number": "708-481-9808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAWST",
"first_name": "PEARL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-06",
"last_updated": "2016-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "247100000X",
"taxonomy_group": "",
"desc": "Radiologic Technologist",
"state": "IL",
"license": "372969",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Olympia Fields, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.