Provider Demographics
NPI:1003894346
Name:NORTH HILL RADIOLOGY SERVICES LLC
Entity type:Organization
Organization Name:NORTH HILL RADIOLOGY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:NEVLING
Authorized Official - Suffix:
Authorized Official - Credentials:PA C
Authorized Official - Phone:319-754-1555
Mailing Address - Street 1:825 N 6TH ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:BURLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52601-4920
Mailing Address - Country:US
Mailing Address - Phone:319-752-8422
Mailing Address - Fax:319-752-4860
Practice Address - Street 1:825 N 6TH ST
Practice Address - Street 2:SUITE 5
Practice Address - City:BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52601-4920
Practice Address - Country:US
Practice Address - Phone:319-752-8422
Practice Address - Fax:319-752-4860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-06
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001000A2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00135646OtherTRM
IA0416784Medicaid
IA0416784Medicaid