Organization Active NPI

Future Diagnostics, LTD.

  • Diagnostic Radiology Physician
  • Chicago, IL
National Provider Identifier
1194872457
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
FUTURE DIAGNOSTICS, LTD.
Practice address
2804 W Devon Ave
Chicago, IL 60659-1502
Phone
(773) 274-7870
Fax
(773) 274-7860
NPI assigned
Jan 5, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Grigoriy Chechelnitskiy
Title
Owner
Phone
(773) 274-7870

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X Primary

Addresses

Primary practice location

2804 W Devon Ave
Chicago, IL 60659-1502

Mailing address

2804 W Devon Ave
Chicago, IL 60659-1502
Phone (773) 274-7870

Other identifiers 1

IdentifierTypeStateIssuer
01621502OtherILBLUE CROSS BLUE SHIELD PR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050125000122 IL Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 0143270504 Practice locations: Lincolnshire, IL

National Provider Directory

National Provider Directory

Locations

430 Milwaukee Ave
Ste 209
Lincolnshire, IL 60069
Phone (847) 383-5435

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194872457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2804 W DEVON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606591502",
            "telephone_number": "773-274-7870",
            "fax_number": "773-274-7860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2804 W DEVON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606591502",
            "telephone_number": "773-274-7870",
            "fax_number": "773-274-7860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUTURE DIAGNOSTICS, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHECHELNITSKIY",
        "authorized_official_first_name": "GRIGORIY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-274-7870",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD PR",
            "identifier": "01621502",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.