Illini Open MRI, LLC

Primary specialty

Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X

Legal business name

ILLINI OPEN MRI, LLC

Practice address

2147 S Neil St
Champaign, IL 61820-7593

Phone

(217) 359-8339

Fax

(217) 359-9833

NPI assigned

May 23, 2005

Last updated

Jun 12, 2008By 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

Mrs. Michelle Douglas

Title

Credentialing Manager

Phone

(502) 403-1401

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213228800000",
    "number": "1417950437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2147 S NEIL ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618207593",
            "telephone_number": "217-359-8339",
            "fax_number": "217-359-9833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2147 S NEIL ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618207593",
            "telephone_number": "217-359-8339",
            "fax_number": "217-359-9833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINI OPEN MRI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-23",
        "last_updated": "2008-06-12",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "502-403-1401",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Magnetic Resonance Imaging (MRI) Clinic/Center in Champaign, IL
• Providers in Champaign, IL by specialty
• Magnetic Resonance Imaging (MRI) Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.

Verify at the official NPI Registry.