NPIMap

Organization Active NPI

Metropolitan Diagnostic Imaging

  • Diagnostic Radiology Physician
  • Chicago, IL
National Provider Identifier
1669483988
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
METROPOLITAN DIAGNOSTIC IMAGING
Practice address
1332 E 47TH St
Chicago, IL 60653-4508
Phone
(773) 624-5400
Fax
(773) 624-5408
NPI assigned
Aug 11, 2006
Last updated
Aug 22, 2020By the provider in NPPES
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
Joel Leland, DO
Title
President/Medical Director
Phone
(312) 807-3555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X Primary

Addresses

Primary practice location

1332 E 47TH St
Chicago, IL 60653-4508

Mailing address

111 N Wabash Ave
Suite 620
Chicago, IL 60602-1903
Phone (312) 807-3555

Other identifiers 1

IdentifierTypeStateIssuer
21621866OtherILBLUE CROSS BLUE SHEILD

Other names 1

  • AMIC Hyde Park Open MRI Other name

National Provider Directory

National Provider Directory
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.

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669483988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N WABASH AVE",
            "address_2": "SUITE 620",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606021903",
            "telephone_number": "312-807-3555",
            "fax_number": "312-807-3922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1332 E 47TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606534508",
            "telephone_number": "773-624-5400",
            "fax_number": "773-624-5408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METROPOLITAN DIAGNOSTIC IMAGING",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LELAND",
        "authorized_official_first_name": "JOEL",
        "authorized_official_title_or_position": "PRESIDENT/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "312-807-3555",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "21621866",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AMIC Hyde Park Open MRI",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chicago, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.