Medrad Clinics, SC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

License

042.617504 Issued in IL

Legal business name

MEDRAD CLINICS, SC

Practice address

1225 Harlem Ave
Forest Park, IL 60130-2407

Phone

(708) 657-4540

Fax

(708) 657-4535

NPI assigned

Aug 1, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth Uzoma Ekechukwu, MD, MPH, FACPNPI 1255331096

Title

President

Phone

(630) 967-4997

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Medrad Clinics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Medrad Clinics SC

  • Internal Medicine Physician
  • Oak Brook, IL
  • NPI 1295155877
  NPD tax ID

Locations

Practitioners 1

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

• Kenneth U Ekechukwu, M.D.

  • Vascular & Interventional Radiology Physician
  • Forest Park, IL
  • NPI 1255331096
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1249084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1780815241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 HARLEM AVE",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601302407",
            "telephone_number": "708-657-4540",
            "fax_number": "708-657-4535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 HARLEM AVE",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601302407",
            "telephone_number": "708-657-4540",
            "fax_number": "708-657-4535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDRAD CLINICS, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-01",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "EKECHUKWU",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "UZOMA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-967-4997",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, MPH, FACP"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "IL",
            "license": "042.617504",
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "IL",
            "license": "042.617504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deandre McLaurin
• Kennedy McMullen, M.D.
• Linda A McVickers
• Rhonda Meacham, LCSW
• Medical Supply Acquisitions, LLC
• Tanya Melich-Munyan, RN
• Ariel Cali Mendelsohn, OTD, OTR/L
• Ralph Menezes, M.D.
• Elsa Marquez Merin, M.D.
• Belmina Michael, M.D.

• Radiology Clinic/Center in Forest Park, IL
• Providers in Forest Park, IL by specialty
• Radiology Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.