Organization
OPEN MRI OF JACKSONVILLE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD R ROMANELLI MD (MD)
(217) 245-0650
Entity
Organization
Contact information
Practice address
1600 W WALNUT ST, JACKSONVILLE, IL 62650-1136
(217) 245-0650
(217) 245-0840
Mailing address
1600 W WALNUT ST, JACKSONVILLE, IL 62650-1136
(217) 245-0650
(217) 245-0840
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00403181
RR MEDICARE
IL
Enumeration date
08/30/2006
Last updated
07/21/2022
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