Chicago Ridge Radiology SC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

CHICAGO RIDGE RADIOLOGY SC

Practice address

9830 Ridgeland Ave
Ste 3
Chicago Ridge, IL 60415-2667

Phone

(708) 423-1819

Fax

(708) 423-4788

NPI assigned

Nov 24, 2009

Organization subpart

No

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

Authorized official

Name

Abdul Amine, MD

Title

Vice President

Phone

(708) 430-3350

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1259020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268784000000",
    "number": "1801124292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2448 S 102ND ST",
            "address_2": "STE 125",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272466",
            "telephone_number": "414-328-3800",
            "fax_number": "414-328-3818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9830 RIDGELAND AVE",
            "address_2": "STE 3",
            "city": "CHICAGO RIDGE",
            "state": "IL",
            "postal_code": "604152667",
            "telephone_number": "708-423-1819",
            "fax_number": "708-423-4788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO RIDGE RADIOLOGY SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-24",
        "last_updated": "2010-03-17",
        "status": "A",
        "authorized_official_last_name": "AMINE",
        "authorized_official_first_name": "ABDUL",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "708-430-3350",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chicago Ridge Immediate Care Inc
• Chicago Ridge Medical Imaging, LLC
• Chicago Ridge Physical Therapy LLC
• Chicago Ridge Radiology SC
• Chicago Ridge Radiology SC
• Chicago Ridge Radiology, S.C.
• Chicago Ridge School District
• Chicago Ridge Skilled Nursing Facility LLC (Avantara Chicago Ridge)
• Chicago Ridge SNF LLC
• Mary Ann Collins, MD

• Multi-Specialty Clinic/Center in Chicago Ridge, IL
• Providers in Chicago Ridge, IL by specialty
• Multi-Specialty Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2010; 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.