Provider Demographics
NPI:1316044340
Name:ADVANTAGE MRI-LEMONT, LLC
Entity Type:Organization
Organization Name:ADVANTAGE MRI-LEMONT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WESTRICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-292-9998
Mailing Address - Street 1:3733 PARK EAST DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4338
Mailing Address - Country:US
Mailing Address - Phone:216-292-9998
Mailing Address - Fax:
Practice Address - Street 1:15900 127TH ST
Practice Address - Street 2:SUITE 121
Practice Address - City:LEMONT
Practice Address - State:IL
Practice Address - Zip Code:60439-2910
Practice Address - Country:US
Practice Address - Phone:630-243-6655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty