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General NPI Number Information
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NPI Number | 1215429501
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Entity Type | Organization
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Legal Business Name | THE OPEN MRI CENTER
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Dates
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Enumeration Date | 06/01/2018
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Last Update Date | 06/01/2018
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Provider Practice Location Address
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Address Line | 3123 WILLIAMSON COUNTY PKWY
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City | MARION
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State | IL
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Zip | 62959-5235
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Country | US
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Telephone | 618-998-8850
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Fax | 618-998-8852
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Provider Business Mailing Address
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Address Line | 112 E CLARK ST
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City | HARRISBURG
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State | IL
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Zip | 62946-2703
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Country | US
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Telephone | 618-926-5808
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Fax | 618-988-8852
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | LANA DILLARD YOUSSEF
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Credential | BS, RVT, RDMS
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Telephone | 618-252-8336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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