PRAIRIE OPEN MRI LLC NPI 1114008000

NPI Information

NPI: 1114008000
Provider Name: PRAIRIE OPEN MRI, LLC
Classification: Clinic/Center - 261QM1200X
Entity Type: Organization

Specialization: Magnetic Resonance Imaging (MRI)

Address:
2450 WOLF RD
UNIT C
WESTCHESTER, IL
ZIP 60154
Phone: (708) 409-1300
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PRAIRIE OPEN MRI, LLC is a magnetic resonance imaging (mri) clinic center in Westchester, IL. PRAIRIE OPEN MRI, LLC NPI is 1114008000. The provider is registered as an organization entity type.

The provider's business location address is:

2450 WOLF RD
UNIT C
WESTCHESTER, IL
ZIP 60154-634
Phone: (708) 409-1300

The provider's authorized official is Edwin C Sage .
The authorized official title is Member Manager and has the following contact phone number (877) 444-4540.

The enumeration date for this NPI number is 10/18/2006 and was last updated on 1/1/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0200X	Clinic/Center	Radiology			No
2	261QM1200X	Clinic/Center	Magnetic Resonance Imaging (MRI)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	215174	MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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