Metropolitan Diagnostic Imaging

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

METROPOLITAN DIAGNOSTIC IMAGING

Doing business as

AMIC Merrionette Park

Practice address

11600 S Kedzie Ave
Merrionette Park, IL 60803-6302

Phone

(708) 377-3730

NPI assigned

Apr 18, 2008

Last updated

Apr 20, 2008By 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

Ms. Michelle Smith

Title

Acct Receivable

Phone

(312) 807-3550

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• AMIC Merrionette Park Doing business as

Tax ID family

Amic Hyde Park Open MRI2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Metropolitan Diagnostic Imaging

  • Diagnostic Radiology Physician
  • Chicago, IL
  • NPI 1669483988
  NPD tax ID

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

{
    "created_epoch": "1208476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1518131606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N WABASH AVE STE 620",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606021914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11600 S KEDZIE AVE",
            "city": "MERRIONETTE PARK",
            "state": "IL",
            "postal_code": "608036302",
            "telephone_number": "708-377-3730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METROPOLITAN DIAGNOSTIC IMAGING",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-18",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "ACCT RECEIVABLE",
        "authorized_official_telephone_number": "312-807-3550",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "21621866",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AMIC Merrionette Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Serafina Marmo
• Demetria McGill
• Melvin McGowan
• Kelly Kathleen McGrail, BCBA
• Kayla Serena Mejia
• Metropolitan Family Services
• Metropolitan Family Services
• Midwest Advanced Radiology Center , LLC
• Witold Jan Mierzwa, PT
• Renita Millhouse

• Diagnostic Radiology Physician in Merrionette Park, IL
• Providers in Merrionette Park, 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 Apr 20, 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.