Envision Diagnostics Inc

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

ENVISION DIAGNOSTICS INC

Practice address

3000 Dundee Rd.
Suite 311
Northbrook, IL 60062

Phone

(224) 235-4821

Fax

(847) 383-6976

NPI assigned

Mar 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Olga Green, PSY.DNPI 1407179302

Title

President

Phone

(847) 494-0126

Specialties & licenses 9

Addresses

Other identifiers 3

Other names 1

• Batuta, Inc. Former legal business name

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 4

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

• Olga Green, PSY.D., MSCP

  • Clinical Psychologist
  • Northbrook, IL
  • NPI 1407179302
  NPD Authorized official
• Edward Neyman, M.D.

  • Diagnostic Radiology Physician
  • Arlington Heights, IL
  • NPI 1104895838
  NPD
• Marina Murphy

  • Professional Counselor
  • Northbrook, IL
  • NPI 1447566625
  NPD (past)
• Alice Shierk-Booth, LCPC

  • Professional Counselor
  • Highland Park, IL
  • NPI 1295389948
  NPD (past)

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455062400000",
    "number": "1710016290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 DUNDEE RD",
            "address_2": "SUITE 311",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622422",
            "telephone_number": "224-235-4821",
            "fax_number": "847-383-6976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 DUNDEE RD.",
            "address_2": "SUITE 311",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "60062",
            "telephone_number": "224-235-4821",
            "fax_number": "847-383-6976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENVISION DIAGNOSTICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2016-02-10",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "OLGA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-494-0126",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "IL",
            "license": "036120986",
            "primary": false
        },
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "IL",
            "license": "036074107",
            "primary": false
        },
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "IL",
            "license": "036105010",
            "primary": false
        },
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "IL",
            "license": "036110490",
            "primary": false
        },
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "IL",
            "license": "036126885",
            "primary": false
        },
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "IL",
            "license": "036108313",
            "primary": false
        },
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "IL",
            "license": "036087491",
            "primary": false
        },
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "IL",
            "license": "036099445",
            "primary": false
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "473809353310",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710016290",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "2233357",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Batuta, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Joshua I English
• Shannon Mary English, MS CCCSLP
• Enso Wellness Center
• Enso Wellness Center
• Envision Care Therapy Inc
• Kyle Epps
• Lauren Fae Epstein Giles, LCSW
• Michael Allen Epstein, M.D.
• Erica C. Ghignone, MD, LLC
• Erica Gaddy Aprn

• Physiological Laboratory in Northbrook, IL
• Providers in Northbrook, IL by specialty
• Physiological Laboratory in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2016; 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.