Ottowa Imaging LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

OTTOWA IMAGING LLC

Practice address

1100 E Norris Dr
Ottawa, IL 61350-1604

Phone

(815) 434-8890

NPI assigned

Oct 9, 2006

Last updated

Aug 22, 2020By 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

Joseph Ben Mallory, M.D.NPI 1649367251

Title

President

Phone

(815) 434-8890

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Joseph Ben Mallory, M.D.

  • Diagnostic Radiology Physician
  • Edina, MN
  • NPI 1649367251
  NPD (past) Authorized official

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962599027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2426",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613507026",
            "telephone_number": "815-434-8890",
            "fax_number": "815-434-8871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E NORRIS DR",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613501604",
            "telephone_number": "815-434-8890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTTOWA IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MALLORY",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "BEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-434-8890",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ottawa Regional Hospital & Healthcare Center (OSF Saint Elizabeth Medical Center)
• Ottawa Regional Hospital & Healthcare Center
• Ottawa Regional Hospital & Healthcare Center (Ottawa Regional Hospice)
• Ottawa Regional Medical Center Inc.
• Ottawa TWP H S Dist 140
• Chanice Owens, LPC
• Danielle Pagano, APN
• Neil Pandya, M.D.
• Molly Elizabeth Panepinto
• Michael Pantig

• Diagnostic Radiology Physician in Ottawa, IL
• Providers in Ottawa, 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 Aug 22, 2020; 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.