Organization
BUCKTOWN OPEN MRI, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWIN SAGE (MEMBER MANAGER)
(773) 772-9988
Entity
Organization
Contact information
Practice address
1717 N ASHLAND AVE, CHICAGO, IL 60622-1449
(773) 772-9988
(773) 772-9989
Mailing address
1717 N ASHLAND AVE, CHICAGO, IL 60622-1449
(773) 772-9988
(773) 772-9989
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
261QR0200X
Radiology Clinic/Center
—
—
Other
Enumeration date
09/24/2013
Last updated
09/26/2013
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