Excell Portable X-Ray Service Inc

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

9251659 Issued in IL

Legal business name

EXCELL PORTABLE X-RAY SERVICE INC

Practice address

2362 Lehman Dr
West Chicago, IL 60185-6169

Phone

(630) 762-8863

Fax

(630) 762-8864

NPI assigned

Apr 21, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Milyne C Masing

Title

Office Administrator

Phone

(630) 762-8863

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Portable X-ray supplier certification: CCN 14X0009859

Legal name

EXCELL PORTABLE X-RAY SERVICE

Certification status

Active

Provider type (POS)

Portable X-ray supplier

Participating since

May 18, 1995

Last certification

Dec 19, 2018

Ownership / control type

Corporation

Facility address

2362 Lehman Drive
West Chicago, IL 60185

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337299200000",
    "number": "1467418137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2362 LEHMAN DR",
            "city": "WEST CHICAGO",
            "state": "IL",
            "postal_code": "601856169",
            "telephone_number": "630-762-8863",
            "fax_number": "630-762-8864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2362 LEHMAN DR",
            "city": "WEST CHICAGO",
            "state": "IL",
            "postal_code": "601856169",
            "telephone_number": "630-762-8863",
            "fax_number": "630-762-8864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELL PORTABLE X-RAY SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-21",
        "last_updated": "2012-05-18",
        "status": "A",
        "authorized_official_last_name": "MASING",
        "authorized_official_first_name": "MILYNE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "630-762-8863",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "9251659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Diagnostic Radiology Physician in West Chicago, IL
• Providers in West Chicago, IL by specialty
• Diagnostic Radiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.