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Organization
MARYVILLE IMAGING, LLC
Active
Organization
MARYVILLE IMAGING, LLC
Active
Parent organization
MARYVILLE IMAGING, LLC
Other names
Goshen Imaging
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARYVILLE IMAGING, LLC
Authorized official
BRIAN DALE ENGELKE (CFO)
(618) 635-4242
Entity
Organization
Contact information
Practice address
3417 ANDERSON HEALTHCARE DR, EDWARDSVILLE, IL 62025-7784
(618) 288-4929
Mailing address
6800 STATE ROUTE 162, MARYVILLE, IL 62062-8500
(618) 288-4929
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
01/18/2022
Last updated
08/04/2022
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