Organization Active NPI

Open MRI at Corporate Woods LLC

  • Diagnostic Radiology Physician
  • Vernon Hills, IL
National Provider Identifier
1114953577
Registry record updated Jun 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
OPEN MRI AT CORPORATE WOODS LLC
Practice address
555 Corporate Woods Pkwy
Vernon Hills, IL 60061-3111
Phone
(847) 883-0308
Fax
(847) 883-0318
NPI assigned
Jun 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2008

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

Authorized official

Name
Donald D Jacobsen
Title
Officer of the Board Secretary
Phone
(952) 543-6500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

555 Corporate Woods Pkwy
Vernon Hills, IL 60061-3111

Mailing address

5775 Wayzata Boulevard
Suite 400
St Louis Park, MN 55416
Phone (952) 542-8553

Other names 1

  • Open MRI at Corporate Woods Doing business as

National Provider Directory

National Provider Directory

Locations

3752 Paysphere Cir
Chicago, IL 60674

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212710400000",
    "number": "1114953577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5775 WAYZATA BOULEVARD",
            "address_2": "SUITE 400",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "55416",
            "telephone_number": "952-542-8553",
            "fax_number": "952-513-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 CORPORATE WOODS PKWY",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600613111",
            "telephone_number": "847-883-0308",
            "fax_number": "847-883-0318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN MRI AT CORPORATE WOODS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2008-06-06",
        "status": "A",
        "authorized_official_last_name": "JACOBSEN",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OFFICER OF THE BOARD SECRETARY",
        "authorized_official_telephone_number": "952-543-6500"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Open MRI at Corporate Woods",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vernon Hills, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2008; 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.