Suburban Radiologists, S.C.
Organization Active NPI Diagnostic Radiology Physician · Lagrange, IL
NPI 1386665396 · NPPES record last updated Sep 12, 2019
Key facts
- NPI
- 1386665396
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- Legal business name
- SUBURBAN RADIOLOGISTS, S.C.
- Practice address
- 5101 S. Willow Springs Rd
Lagrange, IL 60525-2600 - Phone
- (630) 581-6504
- NPI assigned
- Jul 22, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Scott Kwan Lee, MD
- Title
- President
- Phone
- (630) 581-6504
Practitioners 50
-
Benjamin Bienia, MD
-
Katherine Conlon, MD
-
Susan M Ichelle Fanapour, D.O.
-
Neda Saleh Haswah, M.D.
-
Peter Hrabski, M.D.
-
Donna S. Kim, M.D.
-
Tony Kim, M.D.
-
Patricia Lee, M.D.
-
Scott Kwan Lee, M.D.
-
Howard K. O'Neil, M.D.
-
Howard Aaron Pinchcofsky, M.D.
-
Arjun Sharma, MD
-
Suleimaan Waheed, DO
-
Rujman Zaman, M.D.
-
Mita M Majmundar, M.D.
-
Barry D Lessin, MD
-
Mohammed Shilleh, DO
-
Joseph John Porada Jr., M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040921000216 | IL | Part B Supplier - Clinic/Group Practice | 0648248328 |
Receives reassigned benefits from 24 practitioners Practice locations: Bolingbrook, IL; Chicago, IL; Countryside, IL; Glendale Heights, IL; Hinsdale, IL; La Grange, IL; Plainfield, IL; Westmont, IL |
National Provider Directory
Locations
1446 Momentum Pl
Chicago, IL 60689
1415 W 55th St
Ste 104
Countryside, IL 60525
Phone (630) 697-7745
908 N Elm St
Ste 404
Hinsdale, IL 60521
Phone (224) 273-8908
15722 S Route 59
#138
Plainfield, IL 60544
Phone 8154368831201
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician |
2085R0202X | Yes | ||
| Vascular & Interventional Radiology Physician |
2085R0204X |
Addresses
Primary practice location
5101 S. Willow Springs Rd
Lagrange, IL 60525-2600
Mailing address
1446 Momentum Place
Chicago, IL 60689-5314
Phone (630) 581-6504
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CF8050 | Other | IL | MEDICARE RAILROAD |
| 2215114 | Other | IL | BCBS |
Other providers in Lagrange, IL
- Steven Kenneth Sauerberg
- Michael J Schied
- Katherine Dolores Schilder
- Reema Shah
- Laurie A Stewart
- Julie Christine Tumma
- Thomas Will
- Kay Wright
All providers in Lagrange, IL · Diagnostic Radiology Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.