NPIMap

Organization Active NPI

Lakeland Radiologists LTD

  • Diagnostic Radiology Physician
  • Charleston, IL
National Provider Identifier
1891782090
Registry record updated Feb 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
LAKELAND RADIOLOGISTS LTD
Practice address
907 W Lincoln Ave
Charleston, IL 61920-2413
Phone
(312) 574-0076
Fax
(888) 453-0505
NPI assigned
Oct 3, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2014

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

Authorized official

Name
Aldo C Ruffolo, DO
Title
President
Phone
(217) 345-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

907 W Lincoln Ave
Charleston, IL 61920-2413

Mailing address

907 W Lincoln Ave
PO Box 770
Charleston, IL 61920-2413
Phone (217) 235-7701

National Provider Directory

National Provider Directory

Locations

2502 Galen Dr
Ste 101
Champaign, IL 61821
Phone (217) 355-8346

2417 Marshall Ave
Mattoon, IL 61938
Phone (217) 235-3777

3321 Ridgemont Dr
Orange, TX 77630
Phone (409) 883-6052

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391558400000",
    "number": "1891782090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 W LINCOLN AVE",
            "address_2": "PO BOX 770",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "619202413",
            "telephone_number": "217-235-7701",
            "fax_number": "217-345-8366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 W LINCOLN AVE",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "619202413",
            "telephone_number": "312-574-0076",
            "fax_number": "888-453-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKELAND RADIOLOGISTS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-03",
        "last_updated": "2014-02-05",
        "status": "A",
        "authorized_official_last_name": "RUFFOLO",
        "authorized_official_first_name": "ALDO",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-345-2100",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2014; 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.