Provider Demographics
NPI:1467402347
Name:AFFILIATED RADIOLOGISTS, SC
Entity Type:Organization
Organization Name:AFFILIATED RADIOLOGISTS, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:ARCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-563-4275
Mailing Address - Street 1:1725 W HARRISON ST
Mailing Address - Street 2:SUITE 437
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3841
Mailing Address - Country:US
Mailing Address - Phone:312-563-4270
Mailing Address - Fax:312-563-4280
Practice Address - Street 1:1725 W HARRISON ST
Practice Address - Street 2:SUITE 437
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3841
Practice Address - Country:US
Practice Address - Phone:312-563-4270
Practice Address - Fax:312-563-4280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL443580Medicare ID - Type UnspecifiedPROVIDER NUMBER