Provider Demographics
NPI:1710914023
Name:VERTICAL PLUS MRI OF AMERICA, LLC
Entity Type:Organization
Organization Name:VERTICAL PLUS MRI OF AMERICA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:M
Authorized Official - Last Name:KRISTINAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-799-4940
Mailing Address - Street 1:3330 W 177TH ST
Mailing Address - Street 2:UNIT 1D
Mailing Address - City:HAZEL CREST
Mailing Address - State:IL
Mailing Address - Zip Code:60429-2184
Mailing Address - Country:US
Mailing Address - Phone:708-799-1144
Mailing Address - Fax:708-799-0641
Practice Address - Street 1:3838 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-3110
Practice Address - Country:US
Practice Address - Phone:574-257-4674
Practice Address - Fax:574-257-0549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
No2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance ImagingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN255780Medicare PIN