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Organization

PREFERRED OPEN MRI, LTD.

Active
Other names
PREFERRED IMAGING
Organization subpart
No

Provider details

NPI number
Authorized official
MR. NASER RUSTOM (PRESIDENT)
(773) 581-5600
Entity
Organization

Contact information

Practice address
4200 W 63RD ST, CHICAGO, IL 60629-5010
(773) 581-5600
(773) 581-5608
Mailing address
4200 W 63RD ST, CHICAGO, IL 60629-5010
(773) 581-5600
(773) 581-5608

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2471B0102X
Bone Densitometry Radiologic Technologist
2471C3401X
Computed Tomography Radiologic Technologist
2471C3402X
Radiography Radiologic Technologist
2471N0900X
Nuclear Medicine Technology Radiologic Technologist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1632652
BCBS OF ILL PROVIDER NUMB
IL
Enumeration date
05/17/2006
Last updated
06/16/2022
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