MEDRAD CLINICS SC NPI 1780815241

NPI Information

NPI: 1780815241
Provider Name: MEDRAD CLINICS, SC
Classification: Clinic/Center - 261QR0200X
Entity Type: Organization

Specialization: Radiology

CLIA Number: 14D2124332

Address:
1225 HARLEM AVE
FOREST PARK, IL
ZIP 60130
Phone: (708) 657-4540
Get Directions

MEDRAD CLINICS, SC is a radiology clinic center in Forest Park, IL. MEDRAD CLINICS, SC NPI is 1780815241. The provider is registered as an organization entity type.

The provider's business location address is:

1225 HARLEM AVE
FOREST PARK, IL
ZIP 60130-407
Phone: (708) 657-4540
Fax: (708) 657-4535

The provider's authorized official is Kenneth Uzoma Ekechukwu .
The authorized official title is President and has the following contact phone number (630) 967-4997.

The CLIA number assigned to this NPI record is 14D2124332 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 8/1/2009 and was last updated on 7/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QH0100X	Clinic/Center	Health Service	042.617504	ILLINOIS	No
2	261QR0200X	Clinic/Center	Radiology	042.617504	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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