Healthcare Provider Details

I. General information

NPI: 1801062831
Provider Name (Legal Business Name): AURORA RADIOLOGY CONSULTANTS - DEKALB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2008
Last Update Date: 12/18/2019
Certification Date: 12/18/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 KISH HOSPITAL DR ATT RADIOLOGY DEPARTMENT
DEKALB IL
60115
US

IV. Provider business mailing address

1200 HARGER ROAD SUITE 408
OAK BROOK IL
60523
US

V. Phone/Fax

Practice location:
  • Phone: 815-756-1521
  • Fax:
Mailing address:
  • Phone: 630-581-6504
  • Fax: 630-960-0227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES STUDLO
Title or Position: PRESIDENT
Credential: MD
Phone: 630-862-6035