OrganizationActive
Advanced Midwest Interventional Radiology, LLC
NPI 1114438769 · Vascular & Interventional Radiology Physician · New Lenox, IL
Provider details
- NPI number
- 1114438769
- Entity type
- Organization
- Primary specialty
- Vascular & Interventional Radiology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Tarra Grant, Practice Manager(815) 900-9060
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1890 Silver Cross Blvd Ste 450
New Lenox, IL 60451-9518
Phone: (815) 900-9060
Approximate (ZIP-level) locationGet directions
Mailing address
3010 Highland Pkwy Ste 325
Downers Grove, IL 60515-5670
Registry dates
- Enumerated
- 2017-10-21
- Last updated
- 2025-03-07
- Certified
- 2025-03-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.