MEDICARE: 7 HILLS NUCLEAR IMAGING CENTER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0200X	Radiology Clinic/Center	036110141	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437106812
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	7 HILLS NUCLEAR IMAGING CENTER INC

Provider Business Mailing Address
First Line	:	650 SPRING HILL RING RD STE 2000
Second Line	:
City	:	WEST DUNDEE
State	:	IL
Zip	:	60118-1297
Country	:	US
Telephone Number	:	847-428-2273
Fax Number	:	847-428-3128

Provider Business Practice Location Address
First Line	:	650 SPRING HILL RING RD STE 2000
Second Line	:
City	:	WEST DUNDEE
State	:	IL
Zip	:	60118-1297
Country	:	US
Telephone Number	:	847-428-2273
Fax Number	:	847-428-3128

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SRINIVAS R RAVANAM
Credential	:	M.D.
Telephone Number	:	630-369-5544

Provider Enumeration Date	:	05/30/2006
Last Update Date	:	12/21/2010

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