Basic Information
| Provider Information | |||||||||
| NPI: | 1801062831 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AURORA RADIOLOGY CONSULTANTS - DEKALB LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 HARGER ROAD | ||||||||
| Address2: | SUITE 408 | ||||||||
| City: | OAK BROOK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60523 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6305816504 | ||||||||
| FaxNumber: | 6309600227 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 KISH HOSPITAL DR | ||||||||
| Address2: | ATT RADIOLOGY DEPARTMENT | ||||||||
| City: | DEKALB | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60115 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8157561521 | ||||||||
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| ProviderEnumerationDate: | 04/30/2008 | ||||||||
| LastUpdateDate: | 12/18/2019 | ||||||||
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| AuthorizedOfficialLastName: | STUDLO | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6308626035 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 12/18/2019 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.