# NORTHERN OPEN MRI LLC

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

## Provider details

- **NPI number:** 1710932645
- **Authorized official:** PANNA GOSWAMI M.D. (OWNER)
- **Authorized official phone:** (815) 754-4100

## Contact information

- **Practice address:** 1955 DEKALB AVE, SYCAMORE, IL 60178-3107
- **Practice address phone:** (817) 754-4100
- **Practice address fax:** (815) 754-4141
- **Mailing address:** 1955 DEKALB AVE, SYCAMORE, IL 60178-3107
- **Mailing address phone:** (817) 754-4100
- **Mailing address fax:** (815) 754-4141

## Taxonomy

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

## Other

- **Enumeration date:** 05/22/2006
- **Last updated:** 07/21/2022