Organization
STREETERVILLE OPEN MRI, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWIN C SAGE (MEMBER MANAGER)
(877) 444-4540
Entity
Organization
Contact information
Practice address
446 E ONTARIO ST, SUITE 106, CHICAGO, IL 60611-4418
(312) 440-0016
(312) 440-0017
Mailing address
1616 E ROOSEVELT RD, SUITE 5, WHEATON, IL 60187-6850
(877) 444-4540
(847) 550-1488
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
—
261QR0200X
Radiology Clinic/Center
Primary
036068882
IL
Other
Enumeration date
07/07/2006
Last updated
01/11/2012
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