Healthcare Provider Details

I. General information

NPI: 1134605165
Provider Name (Legal Business Name): INSIGHT MEDICAL IMAGING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2018
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2009 WARRENVILLE RD
LISLE IL
60532-1295
US

IV. Provider business mailing address

8930 WAUKEGAN RD STE 130
MORTON GROVE IL
60053-2132
US

V. Phone/Fax

Practice location:
  • Phone: 630-225-4343
  • Fax:
Mailing address:
  • Phone: 847-929-5482
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MARINA ROSSOMAKHA
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 847-929-5482