Healthcare Provider Details
I. General information
NPI: 1962507889
Provider Name (Legal Business Name): RADIOLOGICAL CONSULTANTS OF WOODSTOCK LTD
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/14/2006
Last Update Date: 02/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1555 BARRINGTON RD
HOFFMAN ESTATES IL
60194-1019
US
IV. Provider business mailing address
PO BOX 1690
WOODSTOCK IL
60098-1690
US
V. Phone/Fax
- Phone: 847-843-2000
- Fax:
- Phone: 815-337-1466
- Fax: 815-337-1721
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085B0100X |
| Taxonomy | Body Imaging Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085N0700X |
| Taxonomy | Neuroradiology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085N0904X |
| Taxonomy | Nuclear Radiology Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085P0229X |
| Taxonomy | Pediatric Radiology Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085U0001X |
| Taxonomy | Diagnostic Ultrasound Physician |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DONALD
KASH
Title or Position: CHAIRMAN
Credential: M.D.
Phone: 815-337-1466