Liberty Diagnostic Services

Primary specialty

Sonography Radiologic TechnologistTaxonomy code 2471S1302X

Legal business name

LIBERTY DIAGNOSTIC SERVICES

Practice address

518 S Highway 31
McHenry, IL 60050-7464

Phone

(815) 338-2411

NPI assigned

Jan 9, 2012

Last updated

Jan 9, 2012By 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

Mr. Gary Lee Collett, RDMS

Title

Ceo

Phone

(815) 338-2411

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1326067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326067200000",
    "number": "1669742623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 S HIGHWAY 31",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600507464",
            "telephone_number": "815-338-2411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 S HIGHWAY 31",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600507464",
            "telephone_number": "815-338-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY DIAGNOSTIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-09",
        "last_updated": "2012-01-09",
        "status": "A",
        "authorized_official_last_name": "COLLETT",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "815-338-2411",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RDMS"
    },
    "taxonomies": [
        {
            "code": "2471S1302X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Sonography",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6019701",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chelsey Lesniak
• Francesca Loren Levatino
• Leonard Levites, M.D.
• Lindsey Marie Lhotka
• Yaru Li, DO
• Matthew Lickerman, MD
• Nicole Magdalena Liebmann
• Lifenet, Inc.
• Mercedes E Lim Sebastian, LPT
• Brandon Van Lindgren-Ciero, FNP-BC

• Sonography Radiologic Technologist in McHenry, IL
• Providers in McHenry, IL by specialty
• Sonography Radiologic Technologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2012; 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.