Organization
OPEN ADVANCED MRI OF TINLEY PARK, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY ZEMELA (DIRECTOR)
(708) 444-2101
Entity
Organization
Contact information
Practice address
7711 159TH ST, SUITE 100, TINLEY PARK, IL 60477-1329
(708) 444-2101
(708) 444-2102
Mailing address
7711 159TH ST, SUITE 100, TINLEY PARK, IL 60477-1329
(708) 444-2101
(708) 444-2102
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01632306
BLUE SHIELD
IL
01
—
CJ8757
RAILROAD MEDICARE
IL
Enumeration date
04/17/2006
Last updated
08/22/2020
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