NPIMap

Organization Active NPI

Round Lake Medical Imaging Inc

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Round Lake Beach, IL
National Provider Identifier
1225563380
Registry record updated Apr 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X
License
500505334 Issued in IL
Legal business name
ROUND LAKE MEDICAL IMAGING INC
Practice address
720 E Rollins Rd
Round Lake Beach, IL 60073-1340
Phone
(847) 546-3600
NPI assigned
Apr 26, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2017

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

Authorized official

Name
Mr. Jose Thenganatt
Title
Director
Phone
(847) 922-6306

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X 500505334 IL Primary

Addresses

Primary practice location

720 E Rollins Rd
Round Lake Beach, IL 60073-1340

Mailing address

720 E Rollins Rd
Round Lake Beach, IL 60073-1340
Phone (847) 546-3600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170922001925 IL Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 1850665290 Practice locations: Round Lake Beach, IL

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1493164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493164800000",
    "number": "1225563380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 E ROLLINS RD",
            "city": "ROUND LAKE BEACH",
            "state": "IL",
            "postal_code": "600731340",
            "telephone_number": "847-546-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 E ROLLINS RD",
            "city": "ROUND LAKE BEACH",
            "state": "IL",
            "postal_code": "600731340",
            "telephone_number": "847-546-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROUND LAKE MEDICAL IMAGING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-26",
        "last_updated": "2017-04-26",
        "status": "A",
        "authorized_official_last_name": "THENGANATT",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "847-922-6306",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "IL",
            "license": "500505334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Lake Beach, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2017; 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.