NPIMap

Organization Active NPI

Clinical Radiologists, S.C.

  • Diagnostic Radiology Physician
  • Edwardsville, IL
National Provider Identifier
1700219482
Registry record updated Aug 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
CLINICAL RADIOLOGISTS, S.C.
Practice address
805 Saint Louis St
Edwardsville, IL 62025-1428
Phone
(217) 726-3389
NPI assigned
Aug 16, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2013

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

Authorized official

Name
Thomas C Dickerson
Title
Ceo
Phone
(217) 726-3389

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

805 Saint Louis St
Edwardsville, IL 62025-1428

Mailing address

3050 Montvale Dr
Springfield, IL 62704-4290
Phone (217) 726-3389

National Provider Directory

National Provider Directory
Tax ID family
Clinical Radiologists SC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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": "1376611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376611200000",
    "number": "1700219482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 MONTVALE DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044290",
            "telephone_number": "217-726-3389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 SAINT LOUIS ST",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620251428",
            "telephone_number": "217-726-3389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL RADIOLOGISTS, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-16",
        "last_updated": "2013-08-16",
        "status": "A",
        "authorized_official_last_name": "DICKERSON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "217-726-3389"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edwardsville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2013; 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.