Organization
PREMIER HEALTH SERVICES, INC
Active
Other names
MRI of River North
Organization subpart
No
Provider details
NPI number
Authorized official
CLERISSA HADLEY (REGIONAL DIRECTOR OF NETWORK DEVELO)
(972) 215-7410
Entity
Organization
Contact information
Practice address
559 WEST KINZIE, CHICAGO, IL 60654
(312) 335-1155
(312) 335-9098
Mailing address
PO BOX 674242, DALLAS, TX 75267-4242
(312) 335-1155
(312) 335-9098
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
574840
MEDICARE PTAN
—
Enumeration date
08/13/2005
Last updated
01/12/2018
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