Provider Demographics
NPI:1245490903
Name:CDI GENEVA LLC
Entity type:Organization
Organization Name:CDI GENEVA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SPECIAL ASSISTANT SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:RAMONA
Authorized Official - Middle Name:
Authorized Official - Last Name:AHERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-738-4441
Mailing Address - Street 1:5775 WAYZATA BLVD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1222
Mailing Address - Country:US
Mailing Address - Phone:952-525-6338
Mailing Address - Fax:952-513-6880
Practice Address - Street 1:1416 S RANDALL RD
Practice Address - Street 2:SUITE C1
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-4682
Practice Address - Country:US
Practice Address - Phone:630-208-9325
Practice Address - Fax:630-208-9326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-16
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty