Elk Grove Radiology

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

036062473 Issued in IL

Legal business name

ELK GROVE RADIOLOGY

Practice address

800 Biesterfield Rd
Elk Grove Village, IL 60007-3311

Phone

(847) 437-5500

Fax

(847) 952-7912

NPI assigned

Nov 8, 2006

Last updated

Aug 21, 2019By 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

Dr. Glen Keith Geremia, M.D.

Title

Neuroradiologist

Phone

(847) 437-5500

Specialties & licenses 1

Addresses

Other names 1

• ALEXIAN BROTHERS MEDICAL CENTER Other name

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566345600000",
    "number": "1710057807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073311",
            "telephone_number": "847-437-5500",
            "fax_number": "847-952-7912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073311",
            "telephone_number": "847-437-5500",
            "fax_number": "847-952-7912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELK GROVE RADIOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2019-08-21",
        "status": "A",
        "authorized_official_last_name": "GEREMIA",
        "authorized_official_first_name": "GLEN",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "NEURORADIOLOGIST",
        "authorized_official_telephone_number": "847-437-5500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036062473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ALEXIAN BROTHERS MEDICAL CENTER",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "ALEXIAN BROTHERS MEDICAL CENTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Elk Grove Internal Medicine Associates, S.C.
• Elk Grove Lab Physicians, P.C.
• Elk Grove Medical Associates, LLC
• Elk Grove MRI Inc. (MRI Professionals of Elk Grove)
• Elk Grove Optical, P.C.
• Elk Grove Radiology S.C.
• Elk Grove SLF, LLC
• Elk Grove Smile Center, LLC
• Elk Grove Village Associates, LLP (Alexian Village of Elk Grove)
• Elk Grove Village SLF Associates, L.P.

• Diagnostic Radiology Physician in Elk Grove Village, IL
• Providers in Elk Grove Village, 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 Aug 21, 2019; 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.