Active NPI
Medrad Clinics SC
- Internal Medicine Physician
- Oak Brook, IL
National Provider Identifier
1295155877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 036083256
- Legal business name
- MEDRAD CLINICS SC
- Practice address
- 115 Saint Francis Cir
Oak Brook, IL 60523-2560 - Phone
- (708) 478-2372
- NPI assigned
- Apr 22, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kenneth Ekechukwu, MD
- Title
- President
- Phone
- (708) 323-7608
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036083256 | IL | Primary |
Addresses
Primary practice location
115 Saint Francis Cir
Oak Brook, IL 60523-2560
Mailing address
115 Saint Francis Cir
Oak Brook, IL 60523-2560
Phone (708) 478-2372
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036083256 | Medicaid | IL |
National Provider Directory
National Provider Directory- Tax ID family
- Medrad Clinics
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Radiology Clinic/Center
- Forest Park, IL
- NPI 1780815241
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Vascular & Interventional Radiology Physician
- Forest Park, IL
- NPI 1255331096
Internal Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398124800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1398124800000",
"number": "1295155877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 SAINT FRANCIS CIR",
"city": "OAK BROOK",
"state": "IL",
"postal_code": "605232560",
"telephone_number": "708-478-2372"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 SAINT FRANCIS CIR",
"city": "OAK BROOK",
"state": "IL",
"postal_code": "605232560",
"telephone_number": "708-478-2372"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEDRAD CLINICS SC",
"organizational_subpart": "NO",
"enumeration_date": "2014-04-22",
"last_updated": "2014-04-22",
"status": "A",
"authorized_official_last_name": "EKECHUKWU",
"authorized_official_first_name": "KENNETH",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "708-323-7608",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "IL",
"license": "036083256",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036083256",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oak Brook, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.