4365 Archer MRI, LLC
Organization Active NPI Magnetic Resonance Imaging (MRI) Clinic/Center · Chicago, IL
NPI 1265765218 · NPPES record last updated Sep 9, 2009
Key facts
- NPI
- 1265765218
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X
- License
- 1959633 (IL)
- Legal business name
- 4365 ARCHER MRI, LLC
- Practice address
- 4365 South Archer Avenue
Chicago, IL 60632 - Phone
- (773) 299-1071
- Fax
- (773) 299-1074
- NPI assigned
- Sep 9, 2009
- Organization subpart
- No
Authorized official
- Name
- Dr. Marvin E. Tazelaar
- Title
- Manager
- Phone
- (773) 299-1071
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Magnetic Resonance Imaging (MRI) Clinic/Center | 261QM1200X | 1959633 | IL | Yes |
| Radiology Clinic/Center | 261QR0200X | 1959633 | IL |
Addresses
Primary practice location
4365 South Archer Avenue
Chicago, IL 60632
Mailing address
PO Box 7389
Prospect Heights, IL 60070-7389
Phone (847) 870-3600
Other names
- Archer Open MRI
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.