Active NPI
Professional Radiologic Imaging LTD
- Diagnostic Radiology Physician
- Granite City, IL
National Provider Identifier
1487962692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- Legal business name
- PROFESSIONAL RADIOLOGIC IMAGING LTD
- Practice address
- 2100 Madison Ave
Granite City, IL 62040-4701 - Phone
- (618) 798-3281
- Fax
- (866) 596-7769
- NPI assigned
- Sep 22, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- John Zabrowski, MD
- Title
- President
- Phone
- (618) 259-2047
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | Primary |
Addresses
Primary practice location
2100 Madison Ave
Granite City, IL 62040-4701
Mailing address
17 Junction Dr
#248
Glen Carbon, IL 62034-4300
Phone (618) 798-3281
National Provider Directory
National Provider DirectoryLocations
4802 S State Route 159
Glen Carbon, IL 62034
Phone 61828843883331
17 Junction Dr
#248
Glen Carbon, IL 62034
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285113600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1302048000000",
"number": "1487962692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 JUNCTION DR",
"address_2": "#248",
"city": "GLEN CARBON",
"state": "IL",
"postal_code": "620344300",
"telephone_number": "618-798-3281",
"fax_number": "866-596-7769"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 MADISON AVE",
"city": "GRANITE CITY",
"state": "IL",
"postal_code": "620404701",
"telephone_number": "618-798-3281",
"fax_number": "866-596-7769"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PROFESSIONAL RADIOLOGIC IMAGING LTD",
"organizational_subpart": "NO",
"enumeration_date": "2010-09-22",
"last_updated": "2011-04-06",
"status": "A",
"authorized_official_last_name": "ZABROWSKI",
"authorized_official_first_name": "JOHN",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "618-259-2047",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Granite City, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.