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NPI Code Detail

MEDICARE: SPECIALISTS IN MEDICAL IMAGING, SC

MEDICARE: SPECIALISTS IN MEDICAL IMAGING, SC
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
1363L00000XNurse Practitioner
22085P0229XPediatric Radiology Physician
3363A00000XPhysician Assistant
42085B0100XBody Imaging Physician
52085R0204XVascular & Interventional Radiology Physician
62085R0202XDiagnostic Radiology Physician

General Provider Information

NPI Number : 1841687951
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPECIALISTS IN MEDICAL IMAGING, SC
Provider Business Mailing Address
First Line : PO BOX 85459
Second Line :
City : CHICAGO
State : IL
Zip : 60689-5459
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 20201 CRAWFORD AVE
Second Line :
City : OLYMPIA FIELDS
State : IL
Zip : 60461-1010
Country : US
Telephone Number : 708-747-4000
Fax Number :
Authorized Official
Title or Position : AO
Name : KAREN VAUGHN
Credential :
Telephone Number : 629-317-1465
Provider Enumeration Date : 04/16/2015
Last Update Date : 03/25/2026

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