NPIMap

Organization Active NPI

Macomb Magnetic Resonance Imaging Center Inc

  • Diagnostic Radiology Physician
  • Chicago, IL
National Provider Identifier
1235133141
Registry record updated Mar 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2085R0202X Issued in MI
Legal business name
MACOMB MAGNETIC RESONANCE IMAGING CENTER INC
Practice address
8956 Reliable Parkway
Chicago, IL 60686-0001
Phone
(586) 566-1590
Fax
(586) 498-1559
NPI assigned
Jun 9, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2012

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

Authorized official

Name
Carol Zupan
Title
Administrative Director
Phone
(586) 435-2031

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X 2085R0202X MI Primary

Addresses

Primary practice location

8956 Reliable Parkway
Chicago, IL 60686-0001

Mailing address

42700 Schoenherr Rd
Ste 4
Sterling Heights, MI 48313-2874
Phone (586) 566-1590

Other identifiers 10

IdentifierTypeStateIssuer
300E06180OtherMIBLUE CROSS
84784AOtherMIHEALTH ALLIANCE PLAN
1011238 0001OtherMIWELLNESS PLAN
8332744OtherMIAETNA PPO
P82732OtherMIBLUE CARE NETWORK
104904OtherMIPREFERRED CHOICES
029324OtherMICHAMPUS TRICARE
148900OtherMIGREAT LAKES HEALTH PLAN
2377411OtherMIAETNA HMO
RA820057OtherMIM CARE

Other names 1

  • Macomb MRI Center Doing business as

National Provider Directory

National Provider Directory

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

Locations

8956 Reliable Pkwy
Chicago, IL 60686
Phone (586) 566-1590

42700 Schoenherr Rd
Sterling Heights, MI 48313
Phone (810) 775-6400

42700 Schoenherr Rd
Ste 4
Sterling Hts, MI 48313
Phone (586) 566-1590

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332288000000",
    "number": "1235133141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42700 SCHOENHERR RD",
            "address_2": "STE 4",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483132874",
            "telephone_number": "586-566-1590",
            "fax_number": "586-498-1559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8956 RELIABLE PARKWAY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606860001",
            "telephone_number": "586-566-1590",
            "fax_number": "586-498-1559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACOMB MAGNETIC RESONANCE IMAGING CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-09",
        "last_updated": "2012-03-21",
        "status": "A",
        "authorized_official_last_name": "ZUPAN",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "586-435-2031"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "2085R0202X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "300E06180",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE PLAN",
            "identifier": "84784A",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLNESS PLAN",
            "identifier": "1011238 0001",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "8332744",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "P82732",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CHOICES",
            "identifier": "104904",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS TRICARE",
            "identifier": "029324",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT LAKES HEALTH PLAN",
            "identifier": "148900",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2377411",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M CARE",
            "identifier": "RA820057",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Macomb MRI Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; 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.