Organization Active NPI

Professional Radiologic Imaging LTD

  • Diagnostic Radiology Physician
  • Granite City, IL
National Provider Identifier
1487962692
Registry record updated Apr 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
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

Updated by the provider on Apr 6, 2011

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)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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 Directory

Locations

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.

Verify at the official NPI Registry.