Organization · NPI-2

4365 Archer Mri, LLC

Clinic/Center, Magnetic Resonance Imaging (MRI) · Chicago, IL

NPI number1265765218
StatusActive
Last updated in NPPESSep 9, 2009

Details

NPI
1265765218
Entity type
Organization (NPI-2)
Legal business name
4365 Archer Mri, LLC
Organization subpart
No
Enumeration date
Sep 9, 2009
Last updated
Sep 9, 2009

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM1200X Clinic/Center, Magnetic Resonance Imaging (MRI)1959633ILYes
261QR0200X Clinic/Center, Radiology1959633IL

Other names

  • Archer Open Mri (Doing Business As)

Practice location

4365 South Archer Avenue
Chicago, IL 60632

Phone 773-299-1071 · Fax 773-299-1074

Mailing address

Po Box 7389
Prospect Heights, IL 60070-7389

Phone 847-870-3600 · Fax 847-370-3500

Authorized official

Marvin E. Tazelaar
Manager
7732991071

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