# BUCKTOWN OPEN MRI, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023444890
- **Authorized official:** MR. EDWIN SAGE (MEMBER MANAGER)
- **Authorized official phone:** (773) 772-9988

## Contact information

- **Practice address:** 1717 N ASHLAND AVE, CHICAGO, IL 60622-1449
- **Practice address phone:** (773) 772-9988
- **Practice address fax:** (773) 772-9989
- **Mailing address:** 1717 N ASHLAND AVE, CHICAGO, IL 60622-1449
- **Mailing address phone:** (773) 772-9988
- **Mailing address fax:** (773) 772-9989

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1200X | Magnetic Resonance Imaging (MRI) Clinic/Center | — | NULL | Yes |
| 261QR0200X | Radiology Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 09/24/2013
- **Last updated:** 09/26/2013