Healthcare Provider Details

I. General information

NPI: 1033213475
Provider Name (Legal Business Name): MRI ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 11/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2475 BETHANY ROAD
SYCAMORE IL
60178
US

IV. Provider business mailing address

2475 BETHANY RD
SYCAMORE IL
60178-3116
US

V. Phone/Fax

Practice location:
  • Phone: 815-748-3674
  • Fax: 815-748-3673
Mailing address:
  • Phone: 815-748-3674
  • Fax: 815-748-3673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KATHLEEN G DRATHS-HANSON
Title or Position: PRESIDENT
Credential: MD
Phone: 815-748-3674