Provider Demographics
NPI:1437106812
Name:7 HILLS NUCLEAR IMAGING CENTER INC
Entity Type:Organization
Organization Name:7 HILLS NUCLEAR IMAGING CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SRINIVAS
Authorized Official - Middle Name:R
Authorized Official - Last Name:RAVANAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-369-5544
Mailing Address - Street 1:650 SPRING HILL RING RD STE 2000
Mailing Address - Street 2:
Mailing Address - City:WEST DUNDEE
Mailing Address - State:IL
Mailing Address - Zip Code:60118-1297
Mailing Address - Country:US
Mailing Address - Phone:847-428-2273
Mailing Address - Fax:847-428-3128
Practice Address - Street 1:650 SPRING HILL RING RD STE 2000
Practice Address - Street 2:
Practice Address - City:WEST DUNDEE
Practice Address - State:IL
Practice Address - Zip Code:60118-1297
Practice Address - Country:US
Practice Address - Phone:847-428-2273
Practice Address - Fax:847-428-3128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-30
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036110141261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036110141Medicaid
IL036110141Medicaid