Organization
MIDWEST SPORTS MEDICINE & ORTHOPEDIC SURGICAL SPECIALIST LTD
Active
Other names
Open MRI Imaging Specialists, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
ROSEMARY A MARTIN (ADMINISTRATOR)
(847) 437-9889
Entity
Organization
Contact information
Practice address
901 W BIESTERFIELD ROAD, SUITE 306, ELK GROVE VILLAGE, IL 60007-7324
(847) 437-9889
Mailing address
PO BOX 807, ELK GROVE VILLAGE, IL 60009-0807
(847) 437-9889
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200006961
MEDICARE RAILROAD
IL
01
—
31603457
BCBS
IL
Enumeration date
05/22/2007
Last updated
05/27/2008
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