Organization
DIVISION MRI, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMER RUSTUM MD (OWNER/PRESIDENT)
(773) 456-3384
Entity
Organization
Contact information
Practice address
2618 W DIVISION ST, CHICAGO, IL 60622-7107
(773) 235-7455
(773) 235-7055
Mailing address
PO BOX 220450, CHICAGO, IL 60622-0450
(773) 235-7455
(773) 235-7055
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Enumeration date
03/30/2009
Last updated
01/07/2010
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