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PROVENA HEALTH CENTER FOR DIAGNOSTIC IMAGING
NPI 1720197601
Radiology - Diagnostic Radiology in Bourbonnais, IL

Active since August 30, 2006
100 PROVENA WAY, SUITE 104, BOURBONNAIS, IL 60914(815) 929-5800(815) 929-5801 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Provena Health Center For Diagnostic Imaging NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVENA HEALTH CENTER FOR DIAGNOSTIC IMAGING (NPI 1720197601) is a healthcare organization registered as a diagnostic radiology in Bourbonnais, Illinois and active in the NPI registry since August 2006. The organization lists Edward Molare, President, as its authorized official.

NPPES Registry Identity

NPI1720197601
Entity TypeOrganization
Primary Taxonomy2085R0202X
Legal Business NamePROVENA IMAGING SERVICES INC
Location Address100 PROVENA WAY, SUITE 104Bourbonnais, IL 60914
Mailing Address5775 Wayzata Blvd, Suite 400St Louis Park, MN 55416 · (952) 542-8553 · Fax (952) 513-6880
Phone(815) 929-5800
Fax(815) 929-5801
Organization SubpartNo
Authorized OfficialEdward MolarePresident · (815) 806-2309
Enumeration DateAugust 30, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1720197601 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
100 PROVENA WAY, Bourbonnais, IL 60914
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Other Names 1

Doing Business AsProvena Health Center For Diagnostic Imaging

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARGARET COMFORT PA
Physician Assistant
100 PROVENA WAY, SUITE 103
BOURBONNAIS, IL 60914
Kankakee County (815) 937-8780
PRESENCE HOSPITALS PRV
Internal Medicine (Hematology & Oncology)
100 PROVENA WAY, SUITE 103
BOURBONNAIS, IL 60914
Kankakee County (815) 937-8780
SURESH H WADHWANI M.D. S.C.
Internal Medicine (Cardiovascular Disease)
100 PROVENA WAY
BOURBONNAIS, IL 60914
Kankakee County (815) 936-3200
RADIATION ONCOLOGY OF KANKAKEE
Radiology (Radiation Oncology)
100 PROVENA WAY, SUITE 102
BOURBONNAIS, IL 60914
Kankakee County (815) 937-2460
KANKAKEE RADIATION ONCOLOGY LLC
Radiology (Radiation Oncology)
100 PROVENA WAY, SUITE 102
BOURBONNAIS, IL 60914
Kankakee County (815) 937-2460
LUDAG LLC, DBA CANCER TREATMENT GROUP
Radiology (Radiation Oncology)
100 PROVENA WAY
BOURBONNAIS, IL 60914
Kankakee County (815) 937-2460

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Provena Imaging Services Inc's NPI number?

The NPI number for Provena Imaging Services Inc is 1720197601. It was assigned to this organization in the NPPES registry on August 30, 2006. The provider is doing business as Provena Health Center For Diagnostic Imaging.

Where is Provena Imaging Services Inc located?

Provena Imaging Services Inc is located at 100 Provena Way Suite 104, Bourbonnais, IL 60914. The listed phone number is (815) 929-5800.

What is Provena Imaging Services Inc's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

When was this NPI record last updated?

The NPPES record for Provena Imaging Services Inc was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.