Provider Demographics
NPI:1417059403
Name:WEST REGIONAL MRI LTD PARTNERSHIP
Entity Type:Organization
Organization Name:WEST REGIONAL MRI LTD PARTNERSHIP
Other - Org Name:VISION MRI OF OAK BROOK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTRACTING CREDENTIALING SPECIALIS
Authorized Official - Prefix:
Authorized Official - First Name:GAELANE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-658-0996
Mailing Address - Street 1:2425 W 22ND ST STE 105
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-4647
Mailing Address - Country:US
Mailing Address - Phone:630-990-4674
Mailing Address - Fax:630-572-1455
Practice Address - Street 1:2425 W 22ND ST STE 105
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-4647
Practice Address - Country:US
Practice Address - Phone:630-990-4674
Practice Address - Fax:630-572-1455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory