Open Advanced MRI of Schaumburg, LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

OPEN ADVANCED MRI OF SCHAUMBURG, LLC

Practice address

1834 Walden Office SQ
Suite 125
Schaumburg, IL 60173-4292

Phone

(847) 397-2300

Fax

(847) 397-6140

NPI assigned

Apr 17, 2006

Last updated

Aug 22, 2020By 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

Jerry Zemela

Title

Director

Phone

(847) 397-2300

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265497028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1834 WALDEN OFFICE SQ",
            "address_2": "SUITE 125",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734292",
            "telephone_number": "847-397-2300",
            "fax_number": "847-397-6140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1834 WALDEN OFFICE SQ",
            "address_2": "SUITE 125",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734292",
            "telephone_number": "847-397-2300",
            "fax_number": "847-397-6140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN ADVANCED MRI OF SCHAUMBURG, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ZEMELA",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "847-397-2300"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "01622028",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CI5064",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.