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General NPI Number Information
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NPI Number | 1891129599
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Entity Type | Organization
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Legal Business Name | SMART SCAN MRI, LLC
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Dates
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Enumeration Date | 08/29/2013
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Last Update Date | 10/12/2015
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Provider Practice Location Address
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Address Line | 350 S. GREENLEAF SUITE 401
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City | GURNEE
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State | IL
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Zip | 60031
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Country | US
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Telephone | 847-623-4000
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Fax | 847-623-1005
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Provider Business Mailing Address
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Address Line | 350 S. GREENLEAF SUITE 401
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City | GURNEE
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State | IL
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Zip | 60031
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Country | US
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Telephone | 847-623-4000
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Fax | 847-623-1005
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Authorized Official
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Title or Position | ADMINISTRATIVE DIRECTOR
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Name | MARIA CORONA
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Credential |
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Telephone | 847-623-4000
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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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