Organization Active NPI

Chicago Cardio Diagnostics, L.L.C.

  • Mobile Radiology Clinic/Center
  • Schaumburg, IL
National Provider Identifier
1215984745
Registry record updated Feb 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mobile Radiology Clinic/CenterTaxonomy code 261QR0208X
License
5532-4134 Issued in IL
Legal business name
CHICAGO CARDIO DIAGNOSTICS, L.L.C.
Practice address
270 Willoby CT
Schaumburg, IL 60173-2161
Phone
(847) 995-8001
Fax
(847) 413-0922
NPI assigned
May 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2012

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

Authorized official

Name
Mr. Matthew L Desrosiers
Title
Member
Phone
(847) 995-8001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mobile Radiology Clinic/Center 261QR0208X 5532-4134 IL Primary

Addresses

Primary practice location

270 Willoby CT
Schaumburg, IL 60173-2161

Mailing address

PO Box 59111
Schaumburg, IL 60159-0111
Phone (847) 995-8001

Other identifiers 1

IdentifierTypeStateIssuer
0001635632OtherILBC/BS OF IL PROVIDER #

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328054400000",
    "number": "1215984745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 59111",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601590111",
            "telephone_number": "847-995-8001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 WILLOBY CT",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601732161",
            "telephone_number": "847-995-8001",
            "fax_number": "847-413-0922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO CARDIO DIAGNOSTICS, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-29",
        "last_updated": "2012-02-01",
        "status": "A",
        "authorized_official_last_name": "DESROSIERS",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "847-995-8001",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "IL",
            "license": "5532-4134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF IL PROVIDER #",
            "identifier": "0001635632",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2012; 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.