MEDICAL DIAGNOSTIC SERVICES INC – Diagnostic Radiology Physician, NPI 1912169186
Diagnostic Radiology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for MEDICAL DIAGNOSTIC SERVICES INC
Jarvis Avenue, Skokie South-East Industrial District, Skokie, Niles Township, Cook County, Illinois, 60077, United States
SKOKIE, IL 600764019
Phone: (847) 626-0800
Fax: (847) 626-0819
Type: Mailing
Pontiac Lake Road, Waterford Township, Oakland County, Michigan, 48327:48328, United States
SUITE 1D
WATERFORD, MI 483282059
Phone: (248) 499-7618
Fax: (248) 499-7644
Type: Location
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.
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
Medicare revalidation (CMS due date list)
Revalidation scheduled
Earliest CMS due date is 2026-10-31 (142 days away).
Enrollment records
1
Earliest due date
2026-10-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20071108000663 | O | Clinic/Group Practice | MI | 2026-10-31 |
What to do next
- Monitor the published due date as it approaches.
- Plan to revalidate in PECOS within the window CMS allows before the due date.
- Verify the date on the CMS Revalidation Lookup Tool before submitting.
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 60076)
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