Organization Active NPI

Advanced Radiology, S.C.

  • Diagnostic Radiology Physician
  • Rock Island, IL
National Provider Identifier
1790773539
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
ADVANCED RADIOLOGY, S.C.
Practice address
2701 17TH St
Rock Island, IL 61201-5351
Phone
(815) 315-1718
NPI assigned
Oct 6, 2005
Last updated
Mar 25, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

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

Authorized official

Name
Karen Marie Vaughn
Title
Ao
Phone
(629) 317-1465

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X Primary

Addresses

Primary practice location

2701 17TH St
Rock Island, IL 61201-5351

Mailing address

PO Box 200992
Dallas, TX 75320-0992
Phone (309) 762-1072

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA, WI, FL, MO, VA, OK, TX, MA, CA, UT, OH, AZ, CT, GA, WA, NV, NC, TN, CO, SC, KS, MN, DC24 enrollments

Enrollment records 24

Enrollment IDStateProvider typePAC IDDetails
O20040305000094 IL Part B Supplier - Clinic/Group Practice 2365339207 Receives reassigned benefits from 40 practitioners
Practice locations: Homewood, IL; Moline, IL; Huntley, IL; Morrison, IL; Northfield, IL; Rapids City, IL; Rock Island, IL; Rockford, IL…
O20040308000976 IA Part B Supplier - Clinic/Group Practice 2365339207 Receives reassigned benefits from 21 practitioners
Practice locations: Clinton, IA; Davenport, IA; De Witt, IA; Dubuque, IA; Keokuk, IA; Muscatine, IA; Peosta, IA; Bettendorf, IA
O20150303002430 WI Part B Supplier - Clinic/Group Practice 2365339207 Receives reassigned benefits from 24 practitioners
Practice locations: Lancaster, WI; Madison, WI; Fennimore, WI
O20220126001796 FL Part B Supplier - Clinic/Group Practice 2365339207 Receives reassigned benefits from 10 practitioners
Practice locations: Bradenton, FL; Winter Springs, FL; Winter Garden, FL; Windermere, FL; Tallahassee, FL; Lakewood Ranch, FL; Key West, FL; Hollywood, FL
O20221209000229 MO Part B Supplier - Clinic/Group Practice 2365339207 Receives reassigned benefits from 2 practitioners
Practice locations: Sunrise Beach, MO
O20230719004007 VA Part B Supplier - Clinic/Group Practice 2365339207 Receives reassigned benefits from 3 practitioners
Practice locations: Poquoson, VA
O20231025001885 OK Part B Supplier - Clinic/Group Practice 2365339207 Receives reassigned benefits from 2 practitioners
Practice locations: Muskogee, OK; Edmond, OK; Ada, OK
O20231025002335 TX Part B Supplier - Clinic/Group Practice 2365339207 Receives reassigned benefits from 3 practitioners
Practice locations: Beaumont, TX; Tyler, TX; McAllen, TX; Edinburg, TX
O20231027002125 MA Part B Supplier - Clinic/Group Practice 2365339207 Receives reassigned benefits from 1 practitioner
Practice locations: Westford, MA
O20231113003132 CA Part B Supplier - Clinic/Group Practice 2365339207 Receives reassigned benefits from 4 practitioners
Practice locations: Claremont, CA; Arroyo Grande, CA; Upland, CA; Fremont, CA; Mill Valley, CA
O20231116000701 UT Part B Supplier - Clinic/Group Practice 2365339207 Receives reassigned benefits from 2 practitioners
Practice locations: Heber City, UT; Salt Lake City, UT
O20231127002610 OH Part B Supplier - Clinic/Group Practice 2365339207 Receives reassigned benefits from 1 practitioner
Practice locations: Hilliard, OH
O20231128000750 AZ Part B Supplier - Clinic/Group Practice 2365339207 Receives reassigned benefits from 1 practitioner
Practice locations: Scottsdale, AZ
O20231128001324 CT Part B Supplier - Clinic/Group Practice 2365339207 Receives reassigned benefits from 3 practitioners
Practice locations: Farmington, CT; West Hartford, CT; Woodbridge, CT
O20231129001256 GA Part B Supplier - Clinic/Group Practice 2365339207 Receives reassigned benefits from 1 practitioner
Practice locations: Smyrna, GA
O20231226001632 WA Part B Supplier - Clinic/Group Practice 2365339207 Receives reassigned benefits from 2 practitioners
Practice locations: Seattle, WA; Woodinville, WA
O20240110002992 NV Part B Supplier - Clinic/Group Practice 2365339207 Receives reassigned benefits from 3 practitioners
Practice locations: Las Vegas, NV; Reno, NV
O20240415003891 NC Part B Supplier - Clinic/Group Practice 2365339207 Receives reassigned benefits from 2 practitioners
Practice locations: Chapel Hill, NC; Durham, NC
O20240531001989 TN Part B Supplier - Clinic/Group Practice 2365339207 Receives reassigned benefits from 3 practitioners
Practice locations: Lebanon, TN; Germantown, TN; Memphis, TN
O20240715001943 CO Part B Supplier - Clinic/Group Practice 2365339207 Receives reassigned benefits from 1 practitioner
Practice locations: Castle Pines, CO
O20260203001109 SC Part B Supplier - Clinic/Group Practice 2365339207 Receives reassigned benefits from 1 practitioner
Practice locations: Hardeeville, SC
O20260617000352 KS Part B Supplier - Clinic/Group Practice 2365339207 Receives reassigned benefits from 1 practitioner
Practice locations: Prairie Village, KS
O20260623003138 MN Part B Supplier - Clinic/Group Practice 2365339207 Receives reassigned benefits from 2 practitioners
Practice locations: Rochester, MN; Saint Cloud, MN
O20260628000044 DC Part B Supplier - Clinic/Group Practice 2365339207 Receives reassigned benefits from 1 practitioner
Practice locations: Washington, DC

National Provider Directory

National Provider Directory

Locations

1417 Kimberly Rd
Bettendorf, IA 52722
Phone (563) 742-4350

5185 Competition Dr
Bettendorf, IA 52722
Phone (563) 888-5660

800 N Davis St
Bloomfield, IA 52537
Phone (641) 664-2334

4170 Pennsylvania Ave
Dubuque, IA 52002
Phone (563) 588-0011

3 Pennsylvania Pl
Ottumwa, IA 52501
Phone (641) 683-3372

927 Pennsylvania Ave
Ottumwa, IA 52501
Phone (641) 682-0684

8456 Peosta Commercial Ct
Peosta, IA 52068
Phone (563) 557-2920

104 W 18th Ave
Coal Valley, IL 61240
Phone (309) 779-7581

465 Avenue of the Cities
East Moline, IL 61244
Phone (309) 779-3490

1505 7th St
Moline, IL 61265
Phone (309) 764-8761

3904 16th St
Moline, IL 61265
Phone (309) 581-7610

4300 7th St
Moline, IL 61265
Phone (309) 762-9800

555 Valley View Dr
Moline, IL 61265
Phone (309) 764-9675

615 Valley View Dr
Ste 101
Moline, IL 61265
Phone (309) 743-0445

615 Valley View Dr
Ste 202
Moline, IL 61265
Phone 3097621072311

2550 24th St
Rock Island, IL 61201
Phone (309) 779-7050

700 S Main St
Lapeer, MI 48446
Phone (810) 664-1329

2828 S Park Ave
Lackawanna, NY 14218
Phone (716) 668-1610

500 S Madison St
Lancaster, WI 53813
Phone (608) 723-2020

Practitioners & affiliated clinicians

Practitioners 165

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 165

NPI Registry JSON

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774396800000",
    "number": "1790773539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 200992",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753200992",
            "telephone_number": "309-762-1072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 17TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612015351",
            "telephone_number": "815-315-1718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED RADIOLOGY, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-06",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A",
        "authorized_official_last_name": "VAUGHN",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "AO",
        "authorized_official_telephone_number": "629-317-1465"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Island, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2026; 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.