Providers Medical Imaging and Management

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

PROVIDERS MEDICAL IMAGING AND MANAGEMENT

Practice address

11600 S Kedzie Ave
Suite H
Merrionette Park, IL 60803-6307

Phone

(708) 377-3730

Fax

(708) 293-0255

NPI assigned

Aug 14, 2009

Last updated

Aug 14, 2009By the provider in NPPES

Organization subpart

Yes

Parent organization

AMIC MERRIONETTE PARK, LLCAs reported in NPPES

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

Authorized official

Name

Michael Strotter

Title

Ceo

Phone

(708) 377-3730

Specialties & licenses 1

Addresses

Part of

Providers Medical Imaging and Management

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

{
    "created_epoch": "1250208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250208000000",
    "number": "1851523534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11600 S KEDZIE AVE",
            "address_2": "SUITE H",
            "city": "MERRIONETTE PARK",
            "state": "IL",
            "postal_code": "608036307",
            "telephone_number": "708-377-3730",
            "fax_number": "708-293-0255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11600 S KEDZIE AVE",
            "address_2": "SUITE H",
            "city": "MERRIONETTE PARK",
            "state": "IL",
            "postal_code": "608036307",
            "telephone_number": "708-377-3730",
            "fax_number": "708-293-0255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDERS MEDICAL IMAGING AND MANAGEMENT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMIC MERRIONETTE PARK, LLC",
        "enumeration_date": "2009-08-14",
        "last_updated": "2009-08-14",
        "status": "A",
        "authorized_official_last_name": "STROTTER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "708-377-3730"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Thomas Peslak
• Rhonda Poole, BA
• Jacqueline Anai Potter, MHP
• Premier Cardiac Surgery Center, PLLC
• Premier Vascular, LLC
• Jalisa Ramirez
• Renal Care Group Chicago Southside, LLC (Renal Care Group Merrionette Park)
• Semira Roberts
• Dierra Grace Robinson
• Ebony Robinson

• Radiology Clinic/Center in Merrionette Park, IL
• Providers in Merrionette Park, IL by specialty
• Radiology Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.