Organization Active NPI

Chicago Ridge Radiology SC

  • Multi-Specialty Clinic/Center
  • Chicago Ridge, IL
National Provider Identifier
1548282114
Registry record updated Apr 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
CHICAGO RIDGE RADIOLOGY SC
Practice address
9830 Ridgeland Ave
Ste #4
Chicago Ridge, IL 60415-2667
Phone
(708) 423-1819
Fax
(708) 423-4788
NPI assigned
Jul 24, 2006
Last updated
Apr 1, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2010

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

Authorized official

Name
Abdul Amine, M.D.NPI 1356415350
Title
Vice President
Phone
(708) 430-3350

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

9830 Ridgeland Ave
Ste #4
Chicago Ridge, IL 60415-2667

Mailing address

2448 S 102ND St
Ste 125
West Allis, WI 53227-2466
Phone (414) 328-3800

Other identifiers 1

IdentifierTypeStateIssuer
36043669MedicaidIL

National Provider Directory

National Provider Directory

Locations

7457 Solutions Ctr
#777457
Chicago, IL 60677

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270080000000",
    "number": "1548282114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2448 S 102ND ST",
            "address_2": "STE 125",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272466",
            "telephone_number": "414-328-3800",
            "fax_number": "414-328-3818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9830 RIDGELAND AVE",
            "address_2": "STE #4",
            "city": "CHICAGO RIDGE",
            "state": "IL",
            "postal_code": "604152667",
            "telephone_number": "708-423-1819",
            "fax_number": "708-423-4788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO RIDGE RADIOLOGY SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-24",
        "last_updated": "2010-04-01",
        "status": "A",
        "authorized_official_last_name": "AMINE",
        "authorized_official_first_name": "ABDUL",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "708-430-3350",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36043669",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2010; 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.