Provider Demographics
NPI:1861408213
Name:RADIOLOGY IMAGING SPECIALISTS
Entity type:Organization
Organization Name:RADIOLOGY IMAGING SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:SARKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-928-5234
Mailing Address - Street 1:6910 S MADISON ST
Mailing Address - Street 2:
Mailing Address - City:WILLOWBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60527-5504
Mailing Address - Country:US
Mailing Address - Phone:630-321-2727
Mailing Address - Fax:630-323-1699
Practice Address - Street 1:2800 W 95TH ST
Practice Address - Street 2:LITTLE COMPANY OF MARY HOSPITAL
Practice Address - City:EVERGREEN PARK
Practice Address - State:IL
Practice Address - Zip Code:60805-2701
Practice Address - Country:US
Practice Address - Phone:708-229-5104
Practice Address - Fax:630-323-1699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
022154OtherBCBS
CF6023Medicare PIN
022154OtherBCBS