NPIMap

Organization Active NPI

Northern Illinois Diagnostic Medical Imaging

  • Nuclear Radiology Physician
  • Elmhurst, IL
National Provider Identifier
1396744751
Registry record updated Feb 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Radiology PhysicianTaxonomy code 2085N0904X
Legal business name
NORTHERN ILLINOIS DIAGNOSTIC MEDICAL IMAGING
Practice address
200 Berteau Ave
Elmhurst, IL 60126-2966
Phone
(630) 833-1400
NPI assigned
Jul 19, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2009

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

Authorized official

Name
Robert L Peiss, M.D.NPI 1972505741
Title
Chairman
Phone
(630) 833-1400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085N0904X Primary

Addresses

Primary practice location

200 Berteau Ave
Elmhurst, IL 60126-2966

Mailing address

520 E 22ND St
Lombard, IL 60148-6110
Phone (630) 874-2542

Other names 1

  • Orland Medical Imaging, Inc. Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234137600000",
    "number": "1396744751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 E 22ND ST",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601486110",
            "telephone_number": "630-874-2542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BERTEAU AVE",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262966",
            "telephone_number": "630-833-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN ILLINOIS DIAGNOSTIC MEDICAL IMAGING",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-19",
        "last_updated": "2009-02-09",
        "status": "A",
        "authorized_official_last_name": "PEISS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "630-833-1400",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085N0904X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Nuclear Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orland Medical Imaging, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elmhurst, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2009; 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.