Immaculate Medical Imaging SC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

IMMACULATE MEDICAL IMAGING SC

Practice address

1450 Busch Pkwy Ste 107
Buffalo Grove, IL 60089-4541

Phone

(312) 804-9878

NPI assigned

Sep 8, 2023

Last updated

Oct 17, 2023By 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

Rachit Mendi

Title

President Owner

Phone

(312) 804-9878

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1694131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697500800000",
    "number": "1528845112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 BUSCH PKWY STE 107",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600894541",
            "telephone_number": "312-804-9878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 BUSCH PKWY STE 107",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600894541",
            "telephone_number": "312-804-9878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMACULATE MEDICAL IMAGING SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-08",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A",
        "authorized_official_last_name": "MENDI",
        "authorized_official_first_name": "RACHIT",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "312-804-9878"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; 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.