NPIMap

Organization Active NPI

Oak Brook X-Ray and Imaging, Inc.

  • Body Imaging Physician
  • Oak Brook, IL
National Provider Identifier
1598877185
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Body Imaging PhysicianTaxonomy code 2085B0100X
Legal business name
OAK BROOK X-RAY AND IMAGING, INC.
Practice address
2425 W 22ND St
Suite 104
Oak Brook, IL 60523-1245
Phone
(630) 990-2424
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kianoosh Jafari, M.D.NPI 1902918048
Title
Medical Director
Phone
(630) 990-2424

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085B0100X Primary

Addresses

Primary practice location

2425 W 22ND St
Suite 104
Oak Brook, IL 60523-1245

Mailing address

2425 W 22ND St
Suite 104
Oak Brook, IL 60523-1245
Phone (630) 990-2424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031126000497 IL Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 2961306329 Practice locations: Oak Brook, IL

National Provider Directory

National Provider Directory

Locations

Dept 4149
Carol Stream, IL 60122

2425 W 22nd St
Ste 200
Oak Brook, IL 60523
Phone (630) 954-0054

2425 W 22nd St
Ste 104
Oak Brook, IL 60523
Phone (630) 990-1066

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8699/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598877185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 W 22ND ST",
            "address_2": "SUITE 104",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231245",
            "telephone_number": "630-990-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 W 22ND ST",
            "address_2": "SUITE 104",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231245",
            "telephone_number": "630-990-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK BROOK X-RAY AND IMAGING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JAFARI",
        "authorized_official_first_name": "KIANOOSH",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "630-990-2424",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Body Imaging",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Brook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.