Provider Demographics
NPI:1215225354
Name:KARRI A. VOGT
Entity Type:Organization
Organization Name:KARRI A. VOGT
Other - Org Name:SI IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KARRI
Authorized Official - Middle Name:A
Authorized Official - Last Name:VOGT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-985-6930
Mailing Address - Street 1:110 E ILLINOIS AVE
Mailing Address - Street 2:
Mailing Address - City:CARTERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62918-1747
Mailing Address - Country:US
Mailing Address - Phone:630-985-6930
Mailing Address - Fax:618-985-9576
Practice Address - Street 1:110 E. ILLINOIS AVE
Practice Address - Street 2:
Practice Address - City:CARTERVILLE
Practice Address - State:IL
Practice Address - Zip Code:62918-1747
Practice Address - Country:US
Practice Address - Phone:618-985-6930
Practice Address - Fax:618-985-9576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-11
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL6504OtherPTAN