Organization
PRESENCE AMBULATORY SERVICES
Active
Other names
PRESENCE ADVANCED IMAGING CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELVONNE WICKLIFFE-JONES (CREDENTIALING MGR)
(630) 914-2417
Entity
Organization
Contact information
Practice address
205 S NORTHWEST HWY, SUITE 120, PARK RIDGE, IL 60068-5802
(847) 292-5200
(847) 292-5239
Mailing address
1000 REMINGTON BLVD, SUITE 100, BOLINGBROOK, IL 60440-0000
(630) 914-2417
(630) 914-2499
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
04/27/2012
Last updated
05/29/2013
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