Organization Active NPI

Ultrasound of Belvidere LLC

  • Sonography Radiologic Technologist
  • Belvidere, IL
National Provider Identifier
1376665224
Registry record updated May 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sonography Radiologic TechnologistTaxonomy code 2471S1302X
Legal business name
ULTRASOUND OF BELVIDERE LLC
Practice address
1006 Logan Avenue
Belvidere, IL 61008
Phone
(815) 988-3642
Fax
(815) 544-4775
NPI assigned
Apr 4, 2007
Last updated
May 1, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2008

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

Authorized official

Name
Tina Sabitosra
Title
Owner
Phone
(815) 988-3642

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiography Radiologic Technologist 2471C3402X NU
Sonography Radiologic Technologist 2471S1302X NU Primary

Addresses

Primary practice location

1006 Logan Avenue
Belvidere, IL 61008

Mailing address

1006 Logan Avenue
Belvidere, IL 61008
Phone (815) 988-3642

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080730000050 IL Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 8224102967 Practice locations: Belvidere, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209600000000",
    "number": "1376665224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 LOGAN AVENUE",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "61008",
            "telephone_number": "815-988-3642",
            "fax_number": "815-544-4775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 LOGAN AVENUE",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "61008",
            "telephone_number": "815-988-3642",
            "fax_number": "815-544-4775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULTRASOUND OF BELVIDERE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2008-05-01",
        "status": "A",
        "authorized_official_last_name": "SABITOSRA",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-988-3642"
    },
    "taxonomies": [
        {
            "code": "2471C3402X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Radiography",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2471S1302X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Sonography",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belvidere, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.