Chicago Ridge Radiology, S.C.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

CHICAGO RIDGE RADIOLOGY, S.C.

Practice address

9830 Ridgeland Ave
Suite 4
Chicago Ridge, IL 60415-2667

Phone

(708) 423-1819

Fax

(708) 423-4788

NPI assigned

Jul 9, 2012

Last updated

Jul 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

Aatif Rahman

Title

Administrator

Phone

(708) 423-1819

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1341792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341792000000",
    "number": "1679838320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9830 RIDGELAND AVE",
            "address_2": "SUITE 4",
            "city": "CHICAGO RIDGE",
            "state": "IL",
            "postal_code": "604152667",
            "telephone_number": "708-423-1819",
            "fax_number": "708-423-4788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9830 RIDGELAND AVE",
            "address_2": "SUITE 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, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-09",
        "last_updated": "2012-07-09",
        "status": "A",
        "authorized_official_last_name": "RAHMAN",
        "authorized_official_first_name": "AATIF",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "708-423-1819"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Neuroradiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1548282114",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chicago Ridge Medical Imaging, LLC
• Chicago Ridge Physical Therapy LLC
• Chicago Ridge Radiology SC
• Chicago Ridge Radiology SC
• Chicago Ridge Radiology SC
• Chicago Ridge School District
• Chicago Ridge Skilled Nursing Facility LLC (Avantara Chicago Ridge)
• Chicago Ridge SNF LLC
• Mary Ann Collins, MD
• Jerry Renato Coltro, M.D.

• Diagnostic Radiology Physician in Chicago Ridge, IL
• Providers in Chicago Ridge, IL by specialty
• Diagnostic Radiology Physician in Illinois

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