Provider Demographics
NPI:1013967710
Name:ALPHA MEDICAL IMAGING, LLC
Entity Type:Organization
Organization Name:ALPHA MEDICAL IMAGING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KRESS
Authorized Official - Middle Name:
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-894-0700
Mailing Address - Street 1:11 N ROSELLE RD
Mailing Address - Street 2:
Mailing Address - City:ROSELLE
Mailing Address - State:IL
Mailing Address - Zip Code:60172-1581
Mailing Address - Country:US
Mailing Address - Phone:630-894-0700
Mailing Address - Fax:630-894-0701
Practice Address - Street 1:11 N ROSELLE RD
Practice Address - Street 2:
Practice Address - City:ROSELLE
Practice Address - State:IL
Practice Address - Zip Code:60172-1581
Practice Address - Country:US
Practice Address - Phone:630-894-0700
Practice Address - Fax:630-894-0701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2011-12-22
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
IL210790Medicare PIN
IL508790Medicare PIN
470000331Medicare PIN