Organization
ST VINCENT NORTHWEST RADIOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA A WILGUS (EXECUTIVE DIRECTOR)
(317) 328-5050
Entity
Organization
Contact information
Practice address
11201 USA PKWY, SUITE 140, FISHERS, IN 46037-9202
(317) 913-8910
Mailing address
5901 TECHNOLOGY CENTER DR, INDIANAPOLIS, IN 46278-6013
(317) 328-5050
(317) 715-9965
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200182900
—
IN
Enumeration date
05/12/2006
Last updated
06/18/2009
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