NPIMap

Organization Active NPI

Midwest Imaging & Diagnostic Center Inc

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Oak Lawn, IL
National Provider Identifier
1902844541
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X
Legal business name
MIDWEST IMAGING & DIAGNOSTIC CENTER INC
Practice address
5702 W 95TH St
Suite a
Oak Lawn, IL 60453-2345
Phone
(708) 423-9982
Fax
(708) 423-9984
NPI assigned
Jun 4, 2006
Last updated
Mar 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Authorized official

Name
Sultan TaherNPI 1487692109
Title
Owner
Phone
(708) 423-9982

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X Primary

Addresses

Primary practice location

5702 W 95TH St
Suite a
Oak Lawn, IL 60453-2345

Mailing address

5702 W 95TH St
Suite a
Oak Lawn, IL 60453-2345
Phone (708) 423-9982

Other identifiers 1

IdentifierTypeStateIssuer
212863OtherILPTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060216000065 IL Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 7911912647 Practice locations: Oak Lawn, IL

National Provider Directory

National Provider Directory

Locations

5702 W 95th St
Oak Lawn, IL 60453
Phone (708) 423-9982

5702 W 95th St
Ste A
Oak Lawn, IL 60453
Phone (708) 423-9982

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710892800000",
    "number": "1902844541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5702 W 95TH ST",
            "address_2": "SUITE A",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532345",
            "telephone_number": "708-423-9982",
            "fax_number": "708-423-9984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5702 W 95TH ST",
            "address_2": "SUITE A",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532345",
            "telephone_number": "708-423-9982",
            "fax_number": "708-423-9984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST IMAGING & DIAGNOSTIC CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A",
        "authorized_official_last_name": "TAHER",
        "authorized_official_first_name": "SULTAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-423-9982"
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "212863",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.