Organization
OPEN ADVANCED MRI OF SKOKIE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY PAT HOULIHAN (DIRECTOR)
(847) 329-1674
Entity
Organization
Contact information
Practice address
7152 CARPENTER RD, SKOKIE, IL 60077-3279
(847) 329-1674
(847) 329-0329
Mailing address
7152 CARPENTER RD, SKOKIE, IL 60077-3279
(847) 329-1674
(847) 329-0329
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01635010
BLUE SHIELD
IL
01
—
DD6394
RAILROAD MEDICARE
IL
Enumeration date
04/17/2006
Last updated
08/22/2020
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