Molecular Imaging of Wood Dale, LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

MOLECULAR IMAGING OF WOOD DALE, LLC

Practice address

199 S Addison Rd
Ste 107B
Wood Dale, IL 60191-1929

Phone

(630) 694-6300

Fax

(630) 325-6390

NPI assigned

Mar 4, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Alice Gardner, MPH

Title

Manager

Phone

(630) 325-6300

Specialties & licenses 1

Addresses

Other names 1

• same Former legal business name

Locations

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

{
    "created_epoch": "1204588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1306016530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 S ADDISON RD",
            "address_2": "STE 107B",
            "city": "WOOD DALE",
            "state": "IL",
            "postal_code": "601911929",
            "telephone_number": "630-694-6300",
            "fax_number": "630-325-6390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 S ADDISON RD",
            "address_2": "STE 107B",
            "city": "WOOD DALE",
            "state": "IL",
            "postal_code": "601911929",
            "telephone_number": "630-694-6300",
            "fax_number": "630-325-6390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOLECULAR IMAGING OF WOOD DALE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-04",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "ALICE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "630-325-6300",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MPH"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "same",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• George K. Michalopoulos, D.C.
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• Sarah Miller
• Jennifer Mix, PT
• Nikunj Modi, PHARMD
• Humberto Mui, PHARM.D
• Multicare Home Health
• Debra Nawracaj, FNP-C
• Alexa Neal, MS, CF-SLP
• Neelyx Labs, Inc

• Radiology Clinic/Center in Wood Dale, IL
• Providers in Wood Dale, IL by specialty
• Radiology Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.