Organization
PRESENCE AMBULATORY SERVICES
Active
Other names
Resurrection Open MRI & Imaging Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELVONNE WICKLIFFE-JONES (CREDENTIALING MGR)
(630) 914-2417
Entity
Organization
Contact information
Practice address
3101 N HARLEM AVE, CHICAGO, IL 60634-4532
(773) 836-9360
(773) 745-5522
Mailing address
1000 REMINGTON BLVD, SUITE 100, BOLINGBROOK, IL 60440-0000
(630) 914-2417
(630) 914-2499
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
261QR0200X
Radiology Clinic/Center
—
—
261QR0206X
Mammography Clinic/Center
—
—
Other
Enumeration date
11/16/2009
Last updated
05/29/2013
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