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NPI Code Detail

MEDICARE: PREFERRED OPEN MRI LTD

MEDICARE: PREFERRED OPEN MRI LTD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician42618681IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1216078OTHERILMEDICARE PTAN

General Provider Information

NPI Number : 1598710196
Entity Type Code : Organization
Provider Name (Legal Business Name) : PREFERRED OPEN MRI LTD
Provider Business Mailing Address
First Line : 4200 W 63RD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60629-5010
Country : US
Telephone Number : 773-581-5600
Fax Number : 773-581-5608
Provider Business Practice Location Address
First Line : 4200 W 63RD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60629-5010
Country : US
Telephone Number : 773-581-5600
Fax Number : 773-581-5608
Authorized Official
Title or Position : OFFICE ADMINISTRATOR
Name : MS. NORMA NHOLGUIN
Credential :
Telephone Number : 773-581-5600
Provider Enumeration Date : 05/23/2006
Last Update Date : 06/16/2022

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Directions to “PREFERRED OPEN MRI LTD ” Practice Location

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