Organization
MRI & IMAGING OF WISCONSIN INC
Active
Other names
Kenosha Diagnostic Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL J SCHAEFER (COO)
(770) 300-0101
Entity
Organization
Contact information
Practice address
8500 75TH ST, SUITE 106, KENOSHA, WI 53142-8213
(262) 697-9800
(262) 697-8450
Mailing address
PO BOX 934978, ATLANTA, GA 31193-4978
(866) 659-1211
(336) 774-1751
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21268400
—
WI
01
—
470001862
MEDICARE RR
—
01
—
488503
BC
WI
Enumeration date
05/03/2006
Last updated
12/01/2009
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