Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Provena Imaging Services Inc

Organization Diagnostic Radiology Physician · NPI 1720197601

Provena Imaging Services Inc is a Diagnostic Radiology Physician in Bourbonnais, Illinois. Registered with an NPI since 2006.

In the registry since
2006
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

100 Provena Way Ste 104
Bourbonnais, IL 60914
Phone: (815) 929-5800
Fax: (815) 929-5801
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X

Record details

NPI number1720197601
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Edward Molare — President · (815) 806-2309
Other names Provena Health Center For Diagnostic Imaging
NPI enumeratedAugust 30, 2006
Last updated in NPPESAugust 22, 2020
Mailing address5775 Wayzata Blvd, Suite 400, St Louis Park, MN 55416