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General NPI Number Information
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NPI Number | 1326804436
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Entity Type | Organization
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Legal Business Name | MY MRI LLC
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Dates
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Enumeration Date | 02/26/2024
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Last Update Date | 02/26/2024
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Provider Practice Location Address
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Address Line | 8000 47TH ST
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City | LYONS
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State | IL
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Zip | 60534-1834
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Country | US
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Telephone | 618-318-1816
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Fax |
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Provider Business Mailing Address
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Address Line | 1118 W FULTON MARKET APT 206
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City | CHICAGO
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State | IL
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Zip | 60607-1260
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MADDELYNN HAWKINS
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Credential | MD
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Telephone | 618-318-1816
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number |
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License Number State |
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