Organization Active NPI

Clinton Imaging Services, LLC

  • Radiology Clinic/Center
  • Clinton, IA
National Provider Identifier
1831187665
Registry record updated May 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
CLINTON IMAGING SERVICES, LLC
Practice address
1410 N 4TH St
Suite A102
Clinton, IA 52732-2940
Phone
(563) 244-3674
Fax
(563) 244-3789
NPI assigned
Oct 6, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2013

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

Authorized official

Name
Dr. Craig P. Tillman, M.D.
Title
President
Phone
(309) 762-1072

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary

Addresses

Primary practice location

1410 N 4TH St
Suite A102
Clinton, IA 52732-2940

Mailing address

615 Valley View Dr
Suite 202
Moline, IL 61265-6180
Phone (309) 762-1072

Other identifiers 1

IdentifierTypeStateIssuer
0267013MedicaidIA

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

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

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": "1367366400000",
    "number": "1831187665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 VALLEY VIEW DR",
            "address_2": "SUITE 202",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656180",
            "telephone_number": "309-762-1072",
            "fax_number": "309-762-1094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 N 4TH ST",
            "address_2": "SUITE A102",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527322940",
            "telephone_number": "563-244-3674",
            "fax_number": "563-244-3789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINTON IMAGING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-06",
        "last_updated": "2013-05-01",
        "status": "A",
        "authorized_official_last_name": "TILLMAN",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-762-1072",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0267013",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2013; 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.