Radrad Group of Il SC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

RADRAD GROUP OF IL SC

Practice address

500 N McLean Blvd # 103
Elgin, IL 60123-3275

Phone

(224) 227-6178

Fax

(224) 227-6178

NPI assigned

Mar 30, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Tennyson Maliro, MDNPI 1740427467

Title

Owner/Provider/Authorized Rep

Phone

(301) 503-9055

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

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

• Tennyson M Maliro, M.D.

  • Diagnostic Radiology Physician
  • Elgin, IL
  • NPI 1740427467
  NPD Authorized official
• Rami Doukky, M.D.

  • Cardiovascular Disease Physician
  • Chicago, IL
  • NPI 1093761181
  NPD

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

{
    "created_epoch": "1680134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685664000000",
    "number": "1932803145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7065",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805370065",
            "telephone_number": "970-663-2742",
            "fax_number": "970-667-0847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N MCLEAN BLVD # 103",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601233275",
            "telephone_number": "224-227-6178",
            "fax_number": "224-227-6178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADRAD GROUP OF IL SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-30",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A",
        "authorized_official_last_name": "MALIRO",
        "authorized_official_first_name": "TENNYSON",
        "authorized_official_title_or_position": "OWNER/PROVIDER/AUTHORIZED REP",
        "authorized_official_telephone_number": "301-503-9055",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meliza C Quesea, DDS
• Gloria Quintanilla
• Kathryn Mary Quinton, D.C., P.T.
• Radiant Eye Care
• Radiant Oncology SC
• Marisa Raethz
• Barbara Jacobs Raff, OTRL, CHT
• Marissa Raglin, LCPC
• Amer Rahman, M.D.
• Shahnaz A Rahman, M.D

• Diagnostic Radiology Physician in Elgin, IL
• Providers in Elgin, 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 Jun 2, 2023; 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.