Mid America Radiology Sc

LBN: Mid America Radiology Sc
Mid America Radiology Sc is an health care organization with primary practice located at 1 Good Samaritan Way Radiology Dept, Mount Vernon IL 62864-2402. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as the primary health care specialty. Mid America Radiology Sc can be contacted via phone (618) 242-4600, or through Willis, Jerrold C via phone (618) 242-4600.

Contact Information

Primary practice address
1 Good Samaritan Way Radiology Dept Mount Vernon IL 62864-2402
Phone: (618) 242-4600
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Willis, Jerrold C Doctor of Medicine (MD)
Phone: (618) 242-4600

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X

Profile Details

NPI number 1770538282
LBN Legal business name Mid America Radiology Sc
DBA Doing business as
Authorized official Willis, Jerrold C Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 23rd, 2006
Last updated Mar 15th, 2021 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770538282 NPPES
Illinois Other CB6407 RR/ GOOD SAM & ST MARY'S
Illinois Other CB6408 RR/ GOOD SAM & ST MARY'S

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