Healthcare Provider Details

I. General information

NPI: 1467705988
Provider Name (Legal Business Name): ARIZONA RADIOLOGY IMAGING CONSULTANTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2012
Last Update Date: 10/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 W 156TH ST SUITE 110
HARVEY IL
60426-4260
US

IV. Provider business mailing address

71 W 156TH ST SUITE 110
HARVEY IL
60426-4260
US

V. Phone/Fax

Practice location:
  • Phone: 708-915-5656
  • Fax: 708-915-4022
Mailing address:
  • Phone: 708-915-5656
  • Fax: 708-915-4022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: STEVEN NEWELL
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 708-915-5656