WILFRED V MESINA RT, NPI 1831388479 — CHICAGO (IL)

NPI 1831388479

12+ Years Experience Individual

WILFRED V MESINA RT

10/19/2007
PROVIDER ENUMERATION DATE
10/19/2007
LAST UPDATE DATE
1831388479
NPI NUMBER

About WILFRED V MESINA

Sole proprietor? Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor.

WILFRED V MESINA is a provider established in CHICAGO, IL. The NPI number of WILFRED V MESINA is 1831388479 and was assigned on 10/19/2007. The practitioners primary taxonomy code is: 247100000X IL .

Mailing address

  • City: CHICAGO
  • State: IL
  • Postal code: 606345105
  • Phone: 7738186775
  • Fax: 7736228608
  • Address: 6016 W BARRY AVE

Primary Practice Address

  • Region : CHICAGO, IL
  • NPI : 1831388479
  • Phone : 7738186775
  • Fax : 7736228608
  • Postalcode : 606345105
  • Address : 6016 W BARRY AVE

Additional identifiers

  • Identifier: 3,64E+11
  • Code / Type : 5 - MEDICAID
  • Identifier state : IL

Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Provider taxonomy - Radiologic Technologist

  • Taxonomy code: 247100000X
  • License state: IL

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

Taxonomy description: An individual who is trained and qualified in the art and science of both ionizing and non-ionizing radiation for the purposes of diagnostic medical imaging, interventional procedures and therapeutic treatment.

Contacts:

Click to Show Map
  • WILFRED V MESINA RT
  • Address : 6016 W BARRY AVE
  • Region : CHICAGO, IL
  • NPI : 1831388479
  • Phone : 7738186775
  • Fax : 7736228608
  • Postalcode : 606345105

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

Field Name Value
Provider First Line Business Practice Location Address6016 W BARRY 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 Code606345105
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 Number7738186775
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number7736228608
The fax number associated with the location address of the provider being identified.
NPI1831388479
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1247100000X
An individual who is trained and qualified in the art and science of both ionizing and non-ionizing radiation for the purposes of diagnostic medical imaging, interventional procedures and therapeutic treatment.
Provider Enumeration Date10/19/2007
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated10/19/2007
The date that a record was last updated or changed.
Entity TypeIndividual
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)WILFRED V MESINA
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 Address6016 W BARRY 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 Code606345105
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 Number7738186775
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".
Provider Business Mailing Address Fax Number7736228608
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Healthcare Provider Taxonomy Code #1247100000X
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
An individual who is trained and qualified in the art and science of both ionizing and non-ionizing radiation for the purposes of diagnostic medical imaging, interventional procedures and therapeutic treatment.
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.
Other Provider Identifier 13,64E+11
Other Provider Identifier #1
Other Provider Identifier Type 15
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 1IL
Other Provider Identifier State #1
Provider Gender CodeM
  • M - male
  • F - female
Is sole proprietorY
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

Share this page?