BLOOMINGTON RADIOLOGY S C; NPI #1700831773

Contact Information

BLOOMINGTON RADIOLOGY S C

2200 FORT JESSE RD
SUITE 280
NORMAL, IL 61761-6286

Phone: 309-452-1788
Fax: 309-862-1302
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Diagnostic Radiology	2085R0202X	30	Physician/Diagnostic Radiology
Body Imaging	2085B0100X
Neuroradiology	2085N0700X
Nuclear Radiology	2085N0904X
Vascular & Interventional Radiology	2085R0204X	94	Physician/Interventional Radiology

Indicates primary specialty

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NPI Profile & details for BLOOMINGTON RADIOLOGY S C

NPI # 1700831773

LBN Legal business name BLOOMINGTON RADIOLOGY S C

Authorized official AJAY MALPANI - (PRESIDENT)

Entity Organization

Organization subpart ¹ No

Enumeration date 05/24/2006

Last updated 05/27/2021 - About 5 years ago

Identifiers

License #

042001755

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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BLOOMINGTON RADIOLOGY S C

Contact Information

Specialty

Diagnostic Radiology

Body Imaging

Neuroradiology

Nuclear Radiology

Vascular & Interventional Radiology

NPI Profile & details for BLOOMINGTON RADIOLOGY S C

Reviews for BLOOMINGTON RADIOLOGY S C