Open Advanced MRI of Tinley Park, LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

OPEN ADVANCED MRI OF TINLEY PARK, LLC

Practice address

7711 159TH St
Suite 100
Tinley Park, IL 60477-1329

Phone

(708) 444-2101

Fax

(708) 444-2102

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

Jerry Zemela

Title

Director

Phone

(708) 444-2101

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": "1598720336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7711 159TH ST",
            "address_2": "SUITE 100",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604771329",
            "telephone_number": "708-444-2101",
            "fax_number": "708-444-2102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7711 159TH ST",
            "address_2": "SUITE 100",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604771329",
            "telephone_number": "708-444-2101",
            "fax_number": "708-444-2102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN ADVANCED MRI OF TINLEY PARK, 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": "708-444-2101"
    },
    "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": "RAILROAD MEDICARE",
            "identifier": "CJ8757",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "01632306",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Diagnostic Radiology Physician in Tinley Park, IL
• Providers in Tinley Park, IL by specialty
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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.