Provider Demographics
NPI:1598716771
Name:RADIOLOGY CONSULTANTS OF MID-AMERICA, PC
Entity Type:Organization
Organization Name:RADIOLOGY CONSULTANTS OF MID-AMERICA, PC
Other - Org Name:BELLEVILLE RADIOLOGISTS, LTD
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCHROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:618-235-0955
Mailing Address - Street 1:301 W LINCOLN ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62220-1901
Mailing Address - Country:US
Mailing Address - Phone:618-235-0955
Mailing Address - Fax:618-235-9203
Practice Address - Street 1:180 S 3RD ST
Practice Address - Street 2:SUITE 101
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62220-1952
Practice Address - Country:US
Practice Address - Phone:618-235-0651
Practice Address - Fax:618-235-9722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty