Organization Active NPI

Greenberg Radiology Institute

  • Diagnostic Radiology Physician
  • Highland Park, IL
National Provider Identifier
1477733384
Registry record updated Jan 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
GREENBERG RADIOLOGY INSTITUTE
Practice address
1535 Park Ave W
Highland Park, IL 60035-2240
Phone
(847) 831-0500
Fax
(847) 831-0786
NPI assigned
Nov 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2008

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

Authorized official

Name
Dr. Brent M Greenberg, MD
Title
President
Phone
(847) 831-0500

Specialties & licenses 1

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

Addresses

Primary practice location

1535 Park Ave W
Highland Park, IL 60035-2240

Mailing address

1535 Park Ave W
Highland Park, IL 60035-2240
Phone (847) 831-0500

Other identifiers 1

IdentifierTypeStateIssuer
4915107OtherILBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

1535 Park Ave W
Highland Park, IL 60035
Phone (847) 831-0500

NPI Registry JSON

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

{
    "created_epoch": "1194393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199404800000",
    "number": "1477733384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1535 PARK AVE W",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600352240",
            "telephone_number": "847-831-0500",
            "fax_number": "847-831-0786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 PARK AVE W",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600352240",
            "telephone_number": "847-831-0500",
            "fax_number": "847-831-0786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENBERG RADIOLOGY INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-07",
        "last_updated": "2008-01-04",
        "status": "A",
        "authorized_official_last_name": "GREENBERG",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-831-0500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4915107",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2008; 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.