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Organization

VILLAGE IMAGAING PROFESSIONAL LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN CONNOLLY M.D. (CHARIMAN)
(312) 770-3990
Entity
Organization

Contact information

Practice address
2233 W DIVISION ST, CHICAGO, IL 60622-3043
(312) 770-3990
Mailing address
2233 W DIVISION ST, CHICAGO, IL 60622-3043
(312) 770-3990

Taxonomy

Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
2085N0700X
Neuroradiology Physician
2085N0904X
Nuclear Radiology Physician
2085P0229X
Pediatric Radiology Physician
2085R0202X
Diagnostic Radiology Physician
2085R0203X
Therapeutic Radiology Physician
2085R0204X
Vascular & Interventional Radiology Physician
2085U0001X
Diagnostic Ultrasound Physician

Other

Enumeration date
09/20/2006
Last updated
10/18/2010
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