Healthcare Provider Details

I. General information

NPI: 1104376987
Provider Name (Legal Business Name): SMART CHOICE MRI, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2016
Last Update Date: 10/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2830 S HIGHLAND AVE UNIT 9
LOMBARD IL
60148-7135
US

IV. Provider business mailing address

2830 S HIGHLAND AVE UNIT 9
LOMBARD IL
60148-7135
US

V. Phone/Fax

Practice location:
  • Phone: 844-633-3674
  • Fax:
Mailing address:
  • Phone: 844-633-3674
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE HERBST
Title or Position: CCO
Credential:
Phone: 414-807-5733