Open Advanced MRI of Round Lake, LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

OPEN ADVANCED MRI OF ROUND LAKE, LLC

Practice address

720 E Rollins Rd
Round Lake Beach, IL 60073-1340

Phone

(847) 546-3600

Fax

(847) 546-3633

NPI assigned

Apr 17, 2006

Organization subpart

No

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

Authorized official

Name

Mary Pat Houlihan

Title

Director

Phone

(847) 546-3600

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": "1285699033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 E ROLLINS RD",
            "city": "ROUND LAKE BEACH",
            "state": "IL",
            "postal_code": "600731340",
            "telephone_number": "847-546-3600",
            "fax_number": "847-546-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 E ROLLINS RD",
            "city": "ROUND LAKE BEACH",
            "state": "IL",
            "postal_code": "600731340",
            "telephone_number": "847-546-3600",
            "fax_number": "847-546-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN ADVANCED MRI OF ROUND LAKE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOULIHAN",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "PAT",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "847-546-3600"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "04932279",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DB1792",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Diagnostic Radiology Physician in Round Lake Beach, IL
• Providers in Round Lake Beach, IL by specialty
• Diagnostic Radiology Physician in Illinois

• 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.