NPIMap

Organization Active NPI

Elk Grove Radiology S.C.

  • Diagnostic Radiology Physician
  • Elk Grove Village, IL
National Provider Identifier
1386730810
Registry record updated Aug 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
ELK GROVE RADIOLOGY S.C.
Practice address
800 Biesterfield Rd
Elk Grove Village, IL 60007
Phone
(847) 437-5500
Fax
(847) 952-7912
NPI assigned
Oct 4, 2006
Last updated
Aug 21, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2019

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

Authorized official

Name
Kathleen Kondas
Title
Officer
Phone
(954) 838-2371

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

800 Biesterfield Rd
Elk Grove Village, IL 60007

Mailing address

800 Biesterfield Rd
Elk Grove Village, IL 60007
Phone (954) 838-2371

Other identifiers 2

IdentifierTypeStateIssuer
1635109OtherILBLUE SHIELD OF ILLINOIS
DD3120OtherILRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

75 Remittance Dr
Dept 6500
Chicago, IL 60675

Practitioners & affiliated clinicians

Practitioners 11

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": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566345600000",
    "number": "1386730810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "60007",
            "telephone_number": "954-838-2371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "60007",
            "telephone_number": "847-437-5500",
            "fax_number": "847-952-7912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELK GROVE RADIOLOGY S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2019-08-21",
        "status": "A",
        "authorized_official_last_name": "KONDAS",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "954-838-2371"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF ILLINOIS",
            "identifier": "1635109",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DD3120",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove Village, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2019; 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.