Provider Demographics
NPI:1295846343
Name:JOLIET RADIOLOGICAL SERVICE CORP
Entity type:Organization
Organization Name:JOLIET RADIOLOGICAL SERVICE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD PRES OF CORP
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ARTHOFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-741-7215
Mailing Address - Street 1:333 N MADISON ST
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435
Mailing Address - Country:US
Mailing Address - Phone:815-741-7215
Mailing Address - Fax:815-741-7591
Practice Address - Street 1:333 N MADISON ST
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435
Practice Address - Country:US
Practice Address - Phone:815-741-7215
Practice Address - Fax:815-741-7591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0420000272085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9915352OtherBLUE SHIELD
ILCN3011OtherRAILROAD MEDICARE
ILN200013OtherHARMONY
ILN200013OtherHARMONY