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NPI Code Detail

MEDICARE: PREFERRED OPEN MRI LTD

MEDICARE: PREFERRED OPEN MRI LTD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0200XRadiology Clinic/Center036083121IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21632652OTHERILBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1649374703
Entity Type Code : Organization
Provider Name (Legal Business Name) : PREFERRED OPEN MRI LTD
Provider Business Mailing Address
First Line : 4200 W 63RD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60629-5010
Country : US
Telephone Number : 773-581-5600
Fax Number :
Provider Business Practice Location Address
First Line : 4200 W 63RD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60629-5010
Country : US
Telephone Number : 773-581-5600
Fax Number :
Authorized Official
Title or Position : OFFICE ADMINISTRATOR
Name : MISS HILDA ESCAMILLA
Credential :
Telephone Number : 773-581-5600
Provider Enumeration Date : 09/11/2006
Last Update Date : 06/16/2022

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Directions to “PREFERRED OPEN MRI LTD ” Practice Location

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