Imaging Center of Salem

Primary specialty

Magnetic Resonance Imaging (MRI) Internal Medicine PhysicianTaxonomy code 207RM1200X

Legal business name

IMAGING CENTER OF SALEM

Practice address

1325 W Whittaker St Ste D
Salem, IL 62881-2034

Phone

(618) 548-3796

NPI assigned

Apr 25, 2008

Last updated

Apr 25, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Lu Bogolin

Title

Billing MNGR

Phone

(314) 966-6070

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209081600000",
    "number": "1306011846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31249",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631310249",
            "telephone_number": "314-966-6070",
            "fax_number": "314-966-3440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 W WHITTAKER ST STE D",
            "city": "SALEM",
            "state": "IL",
            "postal_code": "628812034",
            "telephone_number": "618-548-3796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGING CENTER OF SALEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-25",
        "last_updated": "2008-04-25",
        "status": "A",
        "authorized_official_last_name": "BOGOLIN",
        "authorized_official_first_name": "LU",
        "authorized_official_title_or_position": "BILLING MNGR",
        "authorized_official_telephone_number": "314-966-6070",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RM1200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "427080",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "06130188",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI 1ST # GIVEN",
            "identifier": "1235204322",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer N. Holsapple
• Michael J Hourigan, CRNA
• Hoyleton Youth and Family Services
• Brianna Catherine Hoyt, PHARMD
• Karen Huelsmann, PT
• Imaging Center of Salem, Inc
• Innovative Care Elements LLC (Innovative Care Express Series 1)
• Travis James, PA-C
• Megan Jaskowiak
• Hayden Johnson, RBT

• Internal Medicine Physician in Salem, IL
• Providers in Salem, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; 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.