Healthcare Provider Details

I. General information

NPI: 1730632209
Provider Name (Legal Business Name): PREFERRED OPEN MRI LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2016
Last Update Date: 06/17/2022
Certification Date: 06/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 TODD FARM DR
ELGIN IL
60123-1287
US

IV. Provider business mailing address

4200 W 63RD ST
CHICAGO IL
60629-5010
US

V. Phone/Fax

Practice location:
  • Phone: 847-841-8500
  • Fax: 847-841-7268
Mailing address:
  • Phone: 773-581-5600
  • Fax: 773-581-5608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: NORMA HOLGUIN
Title or Position: OFFICE ADMINISTRATOR
Credential:
Phone: 773-581-5600