Medivanta Diagnose LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MEDIVANTA DIAGNOSE LLC

Practice address

504 Crystal CT
Oswego, IL 60543-7937

Phone

(231) 495-9198

NPI assigned

Oct 8, 2026

Last updated

Oct 8, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Ishrat Sultana

Title

Owner

Phone

(231) 495-9198

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1791417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791417600000",
    "number": "1902701212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 CRYSTAL CT",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605437937",
            "telephone_number": "231-495-9198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 CRYSTAL CT",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605437937",
            "telephone_number": "231-495-9198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIVANTA DIAGNOSE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-08",
        "last_updated": "2026-10-08",
        "certification_date": "2026-10-08",
        "status": "A",
        "authorized_official_last_name": "SULTANA",
        "authorized_official_first_name": "ISHRAT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-495-9198",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Oswego, IL
• Providers in Oswego, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2026; 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.