Healthcare Provider Details

I. General information

NPI: 1073618294
Provider Name (Legal Business Name): ADVANCED RADIOLOGY PROFESSIONALS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 03/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 W DUNDEE RD
BUFFALO GROVE IL
60089-4009
US

IV. Provider business mailing address

1420 RENAISSANCE DR SUITE 307
PARK RIDGE IL
60068-1330
US

V. Phone/Fax

Practice location:
  • Phone: 847-797-7226
  • Fax: 847-797-7851
Mailing address:
  • Phone: 847-803-1000
  • Fax: 847-803-1098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Internal Medicine Physician
License Number9256628
License Number StateIL

VIII. Authorized Official

Name: DR. JOHN P ANASTOS
Title or Position: PRESIDENT
Credential: D.O.
Phone: 847-803-1000