Bucktown Open MRI, LLC

Primary specialty

Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X

Legal business name

BUCKTOWN OPEN MRI, LLC

Practice address

1717 N Ashland Ave
Chicago, IL 60622-1449

Phone

(773) 772-9988

Fax

(773) 772-9989

NPI assigned

Sep 24, 2013

Last updated

Sep 26, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Edwin Sage

Title

Member Manager

Phone

(773) 772-9988

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1379980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380153600000",
    "number": "1023444890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 N ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221449",
            "telephone_number": "773-772-9988",
            "fax_number": "773-772-9989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 N ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221449",
            "telephone_number": "773-772-9988",
            "fax_number": "773-772-9989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUCKTOWN OPEN MRI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-24",
        "last_updated": "2013-09-26",
        "status": "A",
        "authorized_official_last_name": "SAGE",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "773-772-9988",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Magnetic Resonance Imaging (MRI) Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Magnetic Resonance Imaging (MRI) Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.