NPIMap

Organization Active NPI

Lake County Imaging, LLC

  • Body Imaging Physician
  • Libertyville, IL
National Provider Identifier
1811224785
Registry record updated Nov 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Body Imaging PhysicianTaxonomy code 2085B0100X
Legal business name
LAKE COUNTY IMAGING, LLC
Practice address
712 S Milwaukee Ave
Libertyville, IL 60048-3279
Phone
(847) 362-1848
NPI assigned
Nov 12, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2009

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

Authorized official

Name
Sandy B Andros
Title
Manager
Phone
(847) 990-1141

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085B0100X Primary

Addresses

Primary practice location

712 S Milwaukee Ave
Libertyville, IL 60048-3279

Mailing address

712 S Milwaukee Ave
Libertyville, IL 60048-3279
Phone (847) 362-1848

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1257984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257984000000",
    "number": "1811224785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 S MILWAUKEE AVE",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483279",
            "telephone_number": "847-362-1848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 S MILWAUKEE AVE",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483279",
            "telephone_number": "847-362-1848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE COUNTY IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-12",
        "last_updated": "2009-11-12",
        "status": "A",
        "authorized_official_last_name": "ANDROS",
        "authorized_official_first_name": "SANDY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "847-990-1141"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Body Imaging",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2009; 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.