Provider Demographics
NPI:1750418851
Name:DELAWARE PLACE MRI,LLC
Entity type:Organization
Organization Name:DELAWARE PLACE MRI,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAGHUVEER
Authorized Official - Middle Name:P
Authorized Official - Last Name:NAYAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-761-0200
Mailing Address - Street 1:7200 N WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-1812
Mailing Address - Country:US
Mailing Address - Phone:773-761-0200
Mailing Address - Fax:773-761-0202
Practice Address - Street 1:33 W DELAWARE PL
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-8115
Practice Address - Country:US
Practice Address - Phone:773-761-0200
Practice Address - Fax:773-761-0202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty