Molecular Imaging of Suburban Chicago, LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

License

0227301 Issued in IL

Legal business name

MOLECULAR IMAGING OF SUBURBAN CHICAGO, LLC

Practice address

230 East Ogden Avenue
Suite 100
Hinsdale, IL 60521-3635

Phone

(630) 325-6300

Fax

(360) 214-2362

NPI assigned

May 27, 2006

Last updated

Nov 8, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Stephanie Tucker

Title

Director

Phone

(630) 755-4327

Specialties & licenses 1

Addresses

Other identifiers 4

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Adventist Midwest Health

  dba Adventist Lagrange Family Medicine Center

  • Family Medicine Physician
  • La Grange, IL
  • NPI 1104953280

  Member Of

  NPD member
• Adventist Midwest Health

  dba Adventhealth Family Medicine Center Hinsdale

  • Family Medicine Physician
  • Hinsdale, IL
  • NPI 1366579443

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478563200000",
    "number": "1467409540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 GRANT SQUARE",
            "address_2": "SUITE 322",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213635",
            "telephone_number": "630-325-6300",
            "fax_number": "630-214-2362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 EAST OGDEN AVENUE",
            "address_2": "SUITE 100",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213635",
            "telephone_number": "630-325-6300",
            "fax_number": "360-214-2362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOLECULAR IMAGING OF SUBURBAN CHICAGO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2016-11-08",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "630-755-4327",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "IL",
            "license": "0227301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEECH STREET",
            "identifier": "21277392246",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0002232827",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ONE CALL MEDICAL",
            "identifier": "ILA10",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7435790",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caroline A Mohlstrom, D.C.
• Lauren Mola
• Molecular Imaging Chicago LLC
• Molecular Imaging of Hinsdale, LLC
• Molecular Imaging of Suburban Chicago LLC
• Julian Moncada, MD
• Elizabeth Montgomery
• Christy Joy Moo, LPC
• Victoria Moore
• Nafeesa A Moosabhoy, M.D.

• Radiology Clinic/Center in Hinsdale, IL
• Providers in Hinsdale, IL by specialty
• Radiology Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; 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.