Individual provider Active NPI

Serena Viturawong, MD

  • Diagnostic Radiology Physician
  • Chicago, IL
National Provider Identifier
1336302710
Registry record updated Dec 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036123750 Issued in IL
Practice address
2525 S Michigan Ave
Chicago, IL 60616-2333
Phone
(312) 567-2899
NPI assigned
Jul 7, 2008
Last updated
Dec 12, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2010

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 036123750 IL Primary

Addresses

Primary practice location

2525 S Michigan Ave
Chicago, IL 60616-2333

Mailing address

2525 S Michigan Ave
Chicago, IL 60616-2333
Phone (312) 567-2899

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
I20090806000458 IL Practitioner - Diagnostic Radiology 8426101569 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Iowa, RJ & L Carver College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

1520 W Harrison St
Chicago, IL 60607-3106
Phone (312) 942-5904

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036123750ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Center Diagnostic Radiology CurrentSince Dec 1, 2024 Accepting new patients
Elmhurst Radiologists, SC Diagnostic Radiology CurrentSince Sep 1, 2019 Accepting new patients
Rush University Medical Group Diagnostic Radiology CurrentSince Dec 1, 2024 Accepting new patients

Locations

75 Remittance Dr
Dept 1611
Chicago, IL 60675

2525 S Michigan Ave
Chicago, IL 60616
Phone (312) 355-1153

1520 W Harrison St
Chicago, IL 60607
Phone (312) 226-2371

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

155 E Brush Hill Rd
Elmhurst, IL 60126
Phone (331) 221-3521

1200 S York St
Elmhurst, IL 60126
Phone (630) 527-3200

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292112000000",
    "number": "1336302710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 S MICHIGAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162333",
            "telephone_number": "312-567-2899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 S MICHIGAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162333",
            "telephone_number": "312-567-2899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITURAWONG",
        "first_name": "SERENA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-07",
        "last_updated": "2010-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036123750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.