Organization Active NPI

Radadvantage Illinois, P.C.

  • Diagnostic Radiology Physician
  • Phoenix, AZ
National Provider Identifier
1275870420
Registry record updated Jan 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
RADADVANTAGE ILLINOIS, P.C.
Practice address
3805 E Bell Rd
Suite 5500
Phoenix, AZ 85032-2105
Phone
(602) 910-6887
Fax
(602) 635-1262
NPI assigned
Jan 8, 2013
Last updated
Jan 8, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2013

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

Authorized official

Name
Mr. Brian Hall
Title
Vice President, Operations
Phone
(602) 910-6887

Specialties & licenses 1

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

Addresses

Primary practice location

3805 E Bell Rd
Suite 5500
Phoenix, AZ 85032-2105

Mailing address

1351 4TH St
Suite 300
Santa Monica, CA 90401-1337
Phone (310) 869-4148

National Provider Directory

National Provider Directory

Locations

1351 4th St
Ste 300
Santa Monica, CA 90401

Practitioners & affiliated clinicians

Practitioners 1

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": "1357603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357603200000",
    "number": "1275870420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 4TH ST",
            "address_2": "SUITE 300",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904011337",
            "telephone_number": "310-869-4148",
            "fax_number": "847-854-6725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3805 E BELL RD",
            "address_2": "SUITE 5500",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322105",
            "telephone_number": "602-910-6887",
            "fax_number": "602-635-1262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADADVANTAGE ILLINOIS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-08",
        "last_updated": "2013-01-08",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "VICE PRESIDENT, OPERATIONS",
        "authorized_official_telephone_number": "602-910-6887",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2013; 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.