Neurodiagnostic Services LTD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

NEURODIAGNOSTIC SERVICES LTD

Practice address

2310 York St
#2C
Blue Island, IL 60406-2411

Phone

(708) 388-4902

Fax

(708) 388-0043

NPI assigned

Aug 11, 2006

Organization subpart

No

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

Authorized official

Name

Anthony Stephens, MD

Title

Owner

Phone

(708) 388-4902

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214870400000",
    "number": "1528079977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 OAKMONT LN",
            "address_2": "SUITE 1600",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595511",
            "telephone_number": "630-789-2550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 YORK ST",
            "address_2": "#2C",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "604062411",
            "telephone_number": "708-388-4902",
            "fax_number": "708-388-0043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURODIAGNOSTIC SERVICES LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2008-07-01",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-388-4902",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "031603006",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "CL0157",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACS HEALTHNET",
            "identifier": "131781400",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• MSMC Investors LLC
• MSMC Investors, LLC
• John Peter Muckian Jr., LPC
• Sean Nash
• Janice M Nelson, RD
• Doris Newby-Brisker
• Newport Medical Associates, LTD
• Russell W. Norwood, MD
• Jessica Null, LCSW
• Roseline Chibuzo Nwokeji, FNP

• Neurology Physician in Blue Island, IL
• Providers in Blue Island, IL by specialty
• Neurology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.