Organization
OPEN ADVANCED MRI OF DEER PARK, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM A CURRIE (VICE PRESIDENT)
(847) 550-6740
Entity
Organization
Contact information
Practice address
20530 N RAND RD, SUITE 350, DEER PARK, IL 60010-7233
(847) 550-6740
(847) 550-9997
Mailing address
20530 N RAND RD, SUITE 350, DEER PARK, IL 60010-7233
(847) 550-6740
(847) 550-9997
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04932417
BLUE SHIELD
IL
01
—
DC9431
RAILROAD MEDICARE
IL
Enumeration date
04/17/2006
Last updated
11/24/2015
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