Organization
ILLINI OPEN MRI, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE DOUGLAS (CREDENTIALING MANAGER)
(502) 403-1401
Entity
Organization
Contact information
Practice address
2147 S NEIL ST, CHAMPAIGN, IL 61820-7593
(217) 359-8339
(217) 359-9833
Mailing address
2147 S NEIL ST, CHAMPAIGN, IL 61820-7593
(217) 359-8339
(217) 359-9833
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
Other
Enumeration date
05/23/2005
Last updated
06/12/2008
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