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General NPI Number Information
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NPI Number | 1427978543
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Entity Type | Organization
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Legal Business Name | MAGNOLIA ULTRASOUND IMAGING CENTER, LLC
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Dates
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Enumeration Date | 07/18/2026
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Last Update Date | 07/18/2026
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Provider Practice Location Address
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Address Line | 200 N PEARL ST
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City | SALEM
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State | IL
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Zip | 62881-1532
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Country | US
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Telephone | 618-922-6272
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Fax | 854-238-3132
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Provider Business Mailing Address
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Address Line | 20648 W OAK SHORES DR
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City | WALNUT HILL
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State | IL
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Zip | 62893-9700
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Country | US
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Telephone | 618-694-3955
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Fax | 854-238-3132
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Authorized Official
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Title or Position | OWNER/SONOGRAPHER
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Name | MRS. JAMI LYN JENNINGS
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Credential | RDMS, RT(R)
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Telephone | 618-694-3955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number |
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License Number State |
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