PHC OF BUFFALO GROVE DIAGNOSTIC SERVICES (NPI# 1881975266) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881975266 |
| Entity Type | Organization |
| Organization Name | PHC OF BUFFALO GROVE DIAGNOSTIC SERVICES |
| Other Organization Name | PORTRAIT HEALTH CENTERS DIAGNOSTIC SERVICES |
| Practice Address |
150 W Half Day Rd Suite 105 Buffalo Grove IL 60089-6591 |
| Practice Telephone | 8478683435 |
| Practice Fax Number | 8478595885 |
| Mailing Telephone | 8478683435 |
| Mailing Fax Number | 8478595885 |
| Enumeration Date | 2011-08-30 |
| Last Update Date | 2011-08-31 |
| Authorized Official Name | DR. JACK A MAGGIORE (DIRECTOR) |
| Authorized Official Telephone | 8478683435 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TH0100X |
Psychologist Specialization: Health Service |
Behavioral Health & Social Service Providers | ||
| Y | 293D00000X | Physiological Laboratory | Laboratories |
| Other Name | Type Code |
|---|---|
| Portrait Health Centers Diagnostic Services | Doing Business As Name - Organization |
| Street Address |
150 W HALF DAY RD SUITE 105 |
| City | BUFFALO GROVE |
| State | IL |
| Zip Code | 60089-6591 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851393334 | Irina K Harag | Family Medicine | 150 W Half Day Rd, Suite 101, Buffalo Grove, IL 60089-6591 | 2005-08-13 |
| 1689949877 | Anna Yermol | Dental Hygienist | 150 W Half Day Rd, Suite 203, Buffalo Grove, IL 60089-6591 | 2012-03-20 |
| 1669754495 | Tracy Bernstein | Dietitian, Registered | 150 W Half Day Rd, Suite 105, Buffalo Grove, IL 60089-6591 | 2011-09-19 |
| 1710284419 | Phc of Buffalo Grove Optometry | Optometrist | 150 W Half Day Rd, Suite 105, Buffalo Grove, IL 60089-6591 | 2011-02-16 |
| 1942501325 | Phc of Buffalo Grove Audiology | Audiologist-Hearing Aid Fitter | 150 W Half Day Rd, Suite 105, Buffalo Grove, IL 60089-6591 | 2010-11-16 |
| 1518268986 | Phc of Buffalo Grove Chiropractic | Chiropractor | 150 W Half Day Rd, Suite 105, Buffalo Grove, IL 60089-6591 | 2010-11-16 |
| 1427364876 | Michelle Melissa Mattingly | Audiologist-Hearing Aid Fitter | 150 W Half Day Rd, Suite 105, Buffalo Grove, IL 60089-6591 | 2010-08-24 |
| 1982848933 | Margaret Coreth Smith | Chiropractor | 150 W Half Day Rd, Suite 105, Buffalo Grove, IL 60089-6591 | 2009-04-21 |
| 1225158322 | Irina K. Harag, M.d., Ltd | Specialist | 150 W Half Day Rd, Suite 101, Buffalo Grove, IL 60089-6591 | 2007-03-30 |
| 1013034461 | Jeanie Chung Kim | Physical Therapist | 150 W Half Day Rd, Suite 207, Buffalo Grove, IL 60089-6591 | 2007-03-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841795275 | Mary Elizabeth Strain, Phd LLC | Psychologist | 355 W Dundee Rd Ste 214, Buffalo Grove, IL 60089 | 2018-03-27 |
| 1861906067 | Pdi Medical IIi LLC | Pharmacy | 1623 Barclay Boulevard, Buffalo Grove, IL 60089 | 2017-11-27 |
| 1487165304 | Crystalann Sasha Thomas | Social Worker | 135 N Arlington Heights Rd., 104, Buffalo Grove, IL 60089 | 2017-10-18 |
| 1801315718 | Natalya Sagalov | Psychologist | 1283 Sandhurst Drive, Buffalo Grove, IL 60089 | 2017-09-12 |
| 1770035859 | Transport Auto Inc | Non-emergency Medical Transport (VAN) | 456 Chicory Ln, Buffalo Grove, IL 60089 | 2016-10-25 |
| 1982062535 | Eileen Fang | Occupational Therapist | 858 Horatio Blvd., Buffalo Grove, IL 60089 | 2016-02-10 |
| 1437538345 | Jamie Levin | Social Worker | 830 Belmar Lane, Buffalo Grove, IL 60089 | 2015-05-26 |
| 1669850756 | Cress Chiropractic Inc | Chiropractor | 1176 Mchenry Road, Buffalo Grove, IL 60089 | 2015-05-11 |
| 1801273123 | Vicki Lane Sheehan | Dentist | 2100 Lake Cook Rd., Suite 1100, Buffalo Grove, IL 60089 | 2015-05-06 |
| 1073918629 | Natalya Nagornaya Dds PC | Dentist | 472 Half Day Rd, Buffalo Grove, IL 60089 | 2014-10-24 |
| Find all providers in zip 60089 | ||||
| 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 |
|---|---|---|---|---|
| 1902896277 | Glen Medical Imaging, Inc. | Physiological Laboratory | 251 Milwaukee Ave, Suite 1016, Buffalo Grove, IL 60089-2809 | 2005-10-26 |
| 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 | BUFFALO GROVE |
| Zip Code | 60089 |
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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.