Irving Fuld, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Practice address

2800 W 95TH Street
Little Company of Mary Hospital
Evergreen, IL 60805

Phone

(708) 229-5104

Fax

(630) 323-1699

NPI assigned

Jul 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Blue Island Pathology LTD

  • Cytopathology Physician
  • Blue Island, IL
  • NPI 1023041233
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508885567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6910 SO MADISON",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "60527",
            "telephone_number": "630-321-2715",
            "fax_number": "630-323-1699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 W 95TH STREET",
            "address_2": "LITTLE COMPANY OF MARY HOSPITAL",
            "city": "EVERGREEN",
            "state": "IL",
            "postal_code": "60805",
            "telephone_number": "708-229-5104",
            "fax_number": "630-323-1699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULD",
        "first_name": "IRVING",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0221524519",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dharma Alagaratam, MD
• Steven Domiano, MD
• Bennett Lum, MD
• Danilo Martinez, MD
• Gene Quirini, MD

• Diagnostic Radiology Physician in Evergreen, IL
• Providers in Evergreen, 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 Jul 8, 2007; 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.