Professional Imaging Consultants, PC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

PROFESSIONAL IMAGING CONSULTANTS, PC

Practice address

3614 Victoria Ave
Mount Vernon, IL 62864-2208

Phone

(618) 315-6058

NPI assigned

Aug 30, 2006

Last updated

Mar 15, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jackie St. John

Title

Contracting & Credentialing

Phone

(631) 930-5215

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363305600000",
    "number": "1518077197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W MAIN ST",
            "address_2": "SUITE 108",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "117023027",
            "telephone_number": "631-930-5215",
            "fax_number": "631-517-8007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3614 VICTORIA AVE",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642208",
            "telephone_number": "618-315-6058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL IMAGING CONSULTANTS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2013-03-15",
        "status": "A",
        "authorized_official_last_name": "ST. JOHN",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_title_or_position": "CONTRACTING & CREDENTIALING",
        "authorized_official_telephone_number": "631-930-5215"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Diagnostic Radiology Physician in Mount Vernon, IL
• Providers in Mount Vernon, 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 Mar 15, 2013; 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.