Organization
ILLINOIS DIAGNOSTIC IMAGING, INC
Active
Other names
Springfield MRI & Imaging Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL J SCHAEFER (COO)
(770) 300-0101
Entity
Organization
Contact information
Practice address
319 E MADISON ST, SUITE J, SPRINGFIELD, IL 62701-1035
(217) 528-4770
(217) 528-2154
Mailing address
PO BOX 934988, ATLANTA, GA 31193-4988
(866) 659-1211
(336) 774-1751
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0008432117
BC
IL
01
—
P00164612
MEDICARE RR
—
Enumeration date
05/03/2006
Last updated
12/01/2009
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