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General NPI Number Information
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NPI Number | 1205919982
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Entity Type | Organization
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Legal Business Name | NORTHWESTERN MEDICAL IMAGING LLC
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 01/07/2011
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Provider Practice Location Address
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Address Line | 1946 45TH AVE
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City | MUNSTER
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State | IN
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Zip | 46321-3917
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Country | US
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Telephone | 630-413-4487
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Fax |
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Provider Business Mailing Address
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Address Line | 1946 45TH AVE
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City | MUNSTER
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State | IN
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Zip | 46321-3917
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Country | US
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Telephone | 630-413-4487
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. JOHN R. BARNEY
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Credential |
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Telephone | 219-663-7770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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