Individual provider Active NPI

Regina Liebman, MD

  • Diagnostic Radiology Physician
  • Elmhurst, IL
National Provider Identifier
1265453856
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Practice address
200 N Berteau Ave
Elmhurst, IL 60126-2966
Phone
(630) 833-1400
NPI assigned
Jul 21, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X IL Primary

Addresses

Primary practice location

200 N Berteau Ave
Elmhurst, IL 60126-2966

Mailing address

200 N Berteau Ave
Elmhurst, IL 60126-2966
Phone (630) 833-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110121000524 IL Practitioner - Diagnostic Radiology 3971782004 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Elmhurst Radiologists, SC Diagnostic Radiology CurrentSince Jul 1, 1998 Accepting new patients

Locations

1200 S York St
Elmhurst, IL 60126
Phone (331) 221-5678

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1265453856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N BERTEAU AVE",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262966",
            "telephone_number": "630-833-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N BERTEAU AVE",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262966",
            "telephone_number": "630-833-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBMAN",
        "first_name": "REGINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, IL

Sources for this page

Verify at the official NPI Registry.