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NPI Code Detail

MEDICARE: OPEN MRI OF NORTHERN ILLINOIS, L.L.C.

MEDICARE: OPEN MRI OF NORTHERN ILLINOIS, L.L.C.
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
1261QM1200XMagnetic Resonance Imaging (MRI) Clinic/Center

General Provider Information

NPI Number : 1831192855
Entity Type Code : Organization
Provider Name (Legal Business Name) : OPEN MRI OF NORTHERN ILLINOIS, L.L.C.
Provider Business Mailing Address
First Line : 100 PARAGON DR
Second Line : STE 200
City : MONTVALE
State : NJ
Zip : 07645-1718
Country : US
Telephone Number : 201-573-8080
Fax Number : 201-505-8905
Provider Business Practice Location Address
First Line : 2150 E LAKE COOK RD
Second Line : STE 40C
City : BUFFALO GROVE
State : IL
Zip : 60089-8220
Country : US
Telephone Number : 847-465-3500
Fax Number : 847-465-3510
Authorized Official
Title or Position : CEO
Name : LAWRENCE M. BUCHWALTER
Credential :
Telephone Number : 201-573-8080
Provider Enumeration Date : 05/23/2005
Last Update Date : 08/22/2020

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