Active NPI
Open MRI at Corporate Woods LLC
- Diagnostic Radiology Physician
- Vernon Hills, IL
National Provider Identifier
1114953577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 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
National Provider Directory
National Provider DirectoryLocations
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.