Active NPI
Clinton Imaging Services, LLC
- Radiology Clinic/Center
- Clinton, IA
National Provider Identifier
1831187665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiology Clinic/Center
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0267013 | Medicaid | IA |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Clinton, IA
- NPI 1093845737
Member Of
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.