ADVANCED MIDWEST INTERVENTIONAL RADIOLOGY, LLC – Vascular & Interventional Radiology Physician, NPI 1114438769

ADVANCED MIDWEST INTERVENTIONAL RADIOLOGY, LLC is a healthcare provider. based in New lenox, Illinois. specializing in Vascular & Interventional Radiology Physician. The NPI Number for ADVANCED MIDWEST INTERVENTIONAL RADIOLOGY, LLC is 1114438769

Main info

Organization
Name
ADVANCED MIDWEST INTERVENTIONAL RADIOLOGY, LLC
NPI
1114438769
Phone
(815) 900-9060
Address
1890 SILVER CROSS BLVD STE 450
Authorized Official
MS. TARRA GRANT PRACTICE MANAGER MA
Enumeration Date
21 October 2017
Last Update Date
7 March 2025
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:8State licenses:0Digital endpointsOther names

Provider Addresses for ADVANCED MIDWEST INTERVENTIONAL RADIOLOGY, LLC

  • 1890 SILVER CROSS BLVD STE 450

    NEW LENOX, IL 604519518

    Phone: (815) 900-9060

    Type: Location

  • 1200 HARGER RD STE 408

    OAK BROOK, IL 605231818

    Phone: (630) 581-6524

    Type: Mailing

  • Silver Cross Boulevard, New Lenox, Will County, Illinois, United States

    NEW LENOX, IL 604519546

    Phone: (815) 900-9060

    Type: Location

  • 3010 HIGHLAND PKWY STE 325

    DOWNERS GROVE, IL 605155670

    Phone: (630) 581-6524

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-01-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-02-29 (836 days ago).

Enrollment records

1

Earliest due date

2024-02-29

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20180124001251OClinic/Group PracticeIL2024-02-29

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60451)

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Reviews

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Frequently asked questions

What unique ID ties claims to ADVANCED MIDWEST INTERVENTIONAL RADIOLOGY, LLC?
NPI 1114438769 is assigned to ADVANCED MIDWEST INTERVENTIONAL RADIOLOGY, LLC under the national enumeration system.
Is ADVANCED MIDWEST INTERVENTIONAL RADIOLOGY, LLC's NPI currently valid?
The extract we use shows ADVANCED MIDWEST INTERVENTIONAL RADIOLOGY, LLC as active.
Can you summarize ADVANCED MIDWEST INTERVENTIONAL RADIOLOGY, LLC's specialty in plain language?
Clinically, the directory lists ADVANCED MIDWEST INTERVENTIONAL RADIOLOGY, LLC with Vascular & Interventional Radiology Physician. Clinical services aligned with this taxonomy classification.
What location shows for ADVANCED MIDWEST INTERVENTIONAL RADIOLOGY, LLC?
We surface New Lenox, Illinois for ADVANCED MIDWEST INTERVENTIONAL RADIOLOGY, LLC based on available NPPES addresses.
How can I contact ADVANCED MIDWEST INTERVENTIONAL RADIOLOGY, LLC?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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