Provider Demographics
NPI:1033213475
Name:MRI ASSOCIATES
Entity Type:Organization
Organization Name:MRI ASSOCIATES
Other - Org Name:DEKALB MAGNETIC RESONANCE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:G
Authorized Official - Last Name:DRATHS-HANSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-748-3674
Mailing Address - Street 1:2475 BETHANY RD
Mailing Address - Street 2:
Mailing Address - City:SYCAMORE
Mailing Address - State:IL
Mailing Address - Zip Code:60178-3116
Mailing Address - Country:US
Mailing Address - Phone:815-748-3674
Mailing Address - Fax:815-748-3673
Practice Address - Street 1:2475 BETHANY ROAD
Practice Address - Street 2:
Practice Address - City:SYCAMORE
Practice Address - State:IL
Practice Address - Zip Code:60178
Practice Address - Country:US
Practice Address - Phone:815-748-3674
Practice Address - Fax:815-748-3673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL988950Medicare PIN