Diana O. Iwanik, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

036072868 Issued in IL

Practice address

7435 W. Talcott Avenue
Presence RMC, Radiology Department
Chicago, IL 60631-3745

Phone

(773) 990-7684

Fax

(773) 792-5124

NPI assigned

Jul 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Presence Healthcare Services

  • Multi-Specialty Clinic/Center
  • Elk Grove Village, IL
  • NPI 1932216819
  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1902824915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7435 W. TALCOTT AVENUE",
            "address_2": "PRESENCE RMC, RADIOLOGY DEPARTMENT",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313745",
            "telephone_number": "773-990-7684",
            "fax_number": "773-792-5124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7435 W. TALCOTT AVENUE",
            "address_2": "PRESENCE RMC, RADIOLOGY DEPARTMENT",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313745",
            "telephone_number": "773-990-7684",
            "fax_number": "773-792-5124"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3101 N Harlem Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606344543",
            "country_code": "US",
            "telephone_number": "773-836-9360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IWANIK",
        "first_name": "DIANA",
        "middle_name": "O.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "IL",
            "license": "036072868",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036072868",
            "primary": true
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "IL",
            "license": "036072868",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "IL",
            "license": "036072868",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "IL",
            "license": "036072868",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "IL",
            "license": "036072868",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036072868-2",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD-IL",
            "identifier": "0001619902",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036072868",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "diwanik20624@ce-direct.presencehealth.org",
            "affiliation": "N",
            "address_1": "3101 N Harlem Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606344543",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michelle D Ivy
• Robin Marie Ivy, NP
• Sherann Ivy, APRN-FPA
• Elsa Chiyo A Iwai
• Khattab Iwainat, DPT
• Jan Lei Iwata, DO
• Suzanne Iwaz, M.D.
• Iwona Sobczak MD, SC
• Jennifer F Iwuchukwu, CNM
• Iyad M Alkhouri MD

• Diagnostic Radiology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Diagnostic Radiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; 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.