MEDI RAY PORTABLE INC , NPI 1043339484 — CHICAGO (IL)

NPI 1043339484

13+ Years Experience Organization

MEDI RAY PORTABLE INC

03/28/2007
PROVIDER ENUMERATION DATE
04/20/2008
LAST UPDATE DATE
1043339484
NPI NUMBER

About MEDI RAY PORTABLE INC

MEDI RAY PORTABLE INC is a provider established in CHICAGO, IL. The NPI number of MEDI RAY PORTABLE INC is 1043339484 and was assigned on 03/28/2007. The practitioners primary taxonomy code is: 2471C3402X IL .

Mailing address

  • City: CHICAGO
  • State: IL
  • Postal code: 606314434
  • Phone: 8476859326
  • Address: 7405 N OSCEOLA AVE

Primary Practice Address

  • Region : CHICAGO, IL
  • NPI : 1043339484
  • Phone : 8476859326
  • Postalcode : 606314434
  • Address : 7405 N OSCEOLA AVE

Provider taxonomy - Radiologic Technologist

  • Taxonomy code: 2471C3402X
  • License state: IL

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy group: 193400000X SINGLE SPECIALTY GROUP.

Contacts:

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  • MEDI RAY PORTABLE INC
  • Address : 7405 N OSCEOLA AVE
  • Region : CHICAGO, IL
  • NPI : 1043339484
  • Phone : 8476859326
  • Postalcode : 606314434

Authorized official :

{:AUTHORIZED_OFFICIAL_FIRST_NAME:} {:AUTHORIZED_OFFICIAL_MIDDLE_NAME:} {:AUTHORIZED_OFFICIAL_LAST_NAME:}
  • Phone : 8476859326
  • Title or position : VICE PRESIDENT

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address7405 N OSCEOLA AVE
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameCHICAGO
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameIL
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code606314434
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number8476859326
The telephone number associated with the location address of the provider being identified.
NPI1043339484
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 12471C3402X
Provider Enumeration Date03/28/2007
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated04/20/2008
The date that a record was last updated or changed.
Entity TypeOrganization
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)MEDI RAY PORTABLE INC
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address7405 N OSCEOLA AVE
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameCHICAGO
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameIL
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code606314434
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number8476859326
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Authorized Official Last NameBYRON
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameMICHAEL
The first name of the authorized official
Authorized Official Title or PositionVICE PRESIDENT
The title or position of the authorized official
Authorized Official Name Prefix TextMR.
Authorized Official Name Prefix Text
Authorized Official Telephone Number8476859326
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code #12471C3402X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Radiologic Technologist
Provider License Number State Code 1IL
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
X

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