Organization
FOREST CITY DIAGNOSTIC IMAGING LLC
Active
Other names
Rockford Open MRI, L.L.C.
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA A WABICK (MANAGER)
(708) 675-1500
Entity
Organization
Contact information
Practice address
735 N PERRYVILLE RD, ROCKFORD, IL 61107-6200
(815) 398-1300
(815) 398-3797
Mailing address
735 N PERRYVILLE RD, ROCKFORD, IL 61107-6200
(815) 398-1300
(815) 398-3797
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10123287
BC BS
—
01
—
470000357
RAILROAD MEDICARE
—
Enumeration date
08/31/2006
Last updated
06/12/2019
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