Provider Demographics
NPI:1093062051
Name:MRI OF CHICAGO, LLC
Entity Type:Organization
Organization Name:MRI OF CHICAGO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AATIF
Authorized Official - Middle Name:U
Authorized Official - Last Name:RAHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-203-2753
Mailing Address - Street 1:3855 N CICERO AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-3623
Mailing Address - Country:US
Mailing Address - Phone:773-777-2888
Mailing Address - Fax:773-777-0072
Practice Address - Street 1:3855 N CICERO AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-3623
Practice Address - Country:US
Practice Address - Phone:773-777-2888
Practice Address - Fax:773-777-0072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1528218906OtherNPI
IL1528218906OtherNPI