Provider Demographics
NPI:1376079236
Name:NATIONAL RADIOLOGY CONSULTANTS OF ILLINOIS, LLC
Entity Type:Organization
Organization Name:NATIONAL RADIOLOGY CONSULTANTS OF ILLINOIS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:OKOH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-920-5200
Mailing Address - Street 1:2540 GREEN FOREST LN
Mailing Address - Street 2:STE 101
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558-5388
Mailing Address - Country:US
Mailing Address - Phone:813-920-5200
Mailing Address - Fax:813-920-5228
Practice Address - Street 1:2875 W 19TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60623-3501
Practice Address - Country:US
Practice Address - Phone:813-920-5200
Practice Address - Fax:813-920-5228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty