Organization
OPEN ADVANCED MRI OF WHEATON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY ZEMELA (DIRECTOR)
(630) 510-7050
Entity
Organization
Contact information
Practice address
43 DANADA SQ E, WHEATON, IL 60187-8484
(630) 510-7050
(630) 510-3699
Mailing address
43 DANADA SQ E, WHEATON, IL 60187-8484
(630) 510-7050
(630) 510-3699
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02222285
BLUE SHIELD
IL
01
—
CI7538
RAILROAD MEDICARE
IL
Enumeration date
04/17/2006
Last updated
08/22/2020
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