MEDCO DIAGNOSTIC IMAGING INC (NPI# 1003969841) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003969841 |
| Entity Type | Organization |
| Organization Name | MEDCO DIAGNOSTIC IMAGING INC |
| Practice Address |
900 E Diehl Road Suite 141 Naperville IL 60563-2391 |
| Practice Telephone | 6302459970 |
| Practice Fax Number | 6302459974 |
| Mailing Telephone | 6302459970 |
| Mailing Fax Number | 6302459974 |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2008-06-09 |
| Authorized Official Name | MR. JOE ANTHONY GERACI (PRESIDENT) |
| Authorized Official Telephone | 6302459970 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 293D00000X | Physiological Laboratory | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS | 2219737 | 01 | |
| IL | MEDICARE RAILROAD | 300119392 | 01 |
| Street Address |
900 E DIEHL ROAD SUITE 141 |
| City | NAPERVILLE |
| State | IL |
| Zip Code | 60563-2391 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902884 | Julia Ann Gottschalk | Nurse Practitioner | 1979 Mcdowell Rd, Unit 103, Naperville, IL 60563 | 2020-11-06 |
| 1700484847 | Lee Michael Harms I | Social Worker | 1952 Mcdowell Road, Suite 305, Naperville, IL 60563 | 2020-10-12 |
| 1881208478 | Poornima Swamy Gangaji | Dentist | 760 N, Illinois Rte 59, Ste100, Naperville, IL 60563 | 2020-09-01 |
| 1851901219 | Adiana Lebron | Social Worker | 2948 Artestian Road, Naperville, IL 60563 | 2020-07-31 |
| 1194342014 | Ingrid Lara | Behavioral Analyst | 1975 Mcdowell Rd #101, Naperville, IL 60563 | 2020-06-26 |
| 1396383030 | Jack Kelly | Assistant Behavior Analyst | 1975 Mcdowell Rd. #101, Naperville, IL 60563 | 2019-12-12 |
| 1316583529 | Arvind Ramakrishnan | Behavioral Analyst | 1975 Mcdowell Rd., Naperville, IL 60563 | 2019-11-22 |
| 1679115778 | Melissa Macias | Behavioral Analyst | 1975 Mcdowell Road, #101, Naperville, IL 60563 | 2019-10-10 |
| 1629619275 | Meghann Reid Vizintos | Physician Assistant | 1763 Freedom Dr Ste 117, Naperville, IL 60563 | 2019-10-04 |
| 1417413543 | Vikram Singh Cheema | Physician Assistant | 1335 North Mill Street, Naperville, IL 60563 | 2019-02-13 |
| Find all providers in zip 60563 | ||||
| Taxonomy Code | 293D00000X |
| Grouping | Laboratories |
| Classification | Physiological Laboratory |
| A laboratory that operates independently of a hospital and physician’s office to furnish physiological diagnostic services (e.g. EEG’s , EKG’s, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services. |
| Notes: Source: Paraphrased from the Medicare Carrier Manual, Section 2070.5. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710587852 | Express Medical Labs LLC | Physiological Laboratory | 9830 Ridgeland Ave Ste 115, Chicago Ridge, IL 60415-2667 | 2020-10-28 |
| 1538532874 | Braincare, LLC | Physiological Laboratory | 1 Bio Logic Plz, Ste 1, Mundelein, IL 60060-3708 | 2015-11-09 |
| 1174901920 | Midwest Diagnostics Incorporated | Physiological Laboratory | 1555 S Redwood Dr, Mt Prospect, IL 60056-4906 | 2015-05-13 |
| 1023406477 | Physician Imaging Solutions Inc | Physiological Laboratory | 24012 W Lockport St, Suite 2e, Plainfield, IL 60544-2280 | 2015-01-07 |
| 1356752620 | Primera Healthcare Solutions, Inc. | Physiological Laboratory | 3340 Dundee Rd Ste 2c4, Northbrook, IL 60062-2331 | 2014-05-08 |
| 1053619742 | Valley Regional Health Services L3c | Physiological Laboratory | 4391 Venture Dr, Peru, IL 61354-1014 | 2011-03-04 |
| 1780826230 | Division Mri, Inc. | Physiological Laboratory | 2618 W Division St, Chicago, IL 60622-7107 | 2009-03-30 |
| 1710130539 | Irhythm Technologies, Inc. | Physiological Laboratory | 2 Marriott Dr, Lincolnshire, IL 60069-3700 | 2008-10-23 |
| 1336399583 | Univ. of Illinois At Chicago | Physiological Laboratory | 851 S Morgan St, Seo, Mc 063, Room 218, Chicago, IL 60607-7042 | 2008-09-24 |
| 1407043581 | Effingham Sleep Center, Inc | Physiological Laboratory | 2313 Hoffman Dr, Effingham, IL 62401-2839 | 2007-10-02 |
| Find all providers with the same taxonomy | ||||
| City | NAPERVILLE |
| Zip Code | 60563 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.