Provider Demographics
NPI:1528218906
Name:MRI OF CHICAGO LLC
Entity Type:Organization
Organization Name:MRI OF CHICAGO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:ALAWAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-423-1819
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:2008-09-23
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL1739Medicare PIN