Advanced Imaging of Deerfield, LLC
Organization Active NPI Diagnostic Radiology Physician · Bannockburn, IL
NPI 1629033469 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1629033469
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- Legal business name
- ADVANCED IMAGING OF DEERFIELD, LLC
- Practice address
- 2101 Waukegan Rd
Suite 108
Bannockburn, IL 60015-1836 - Phone
- (847) 374-8100
- Fax
- (847) 374-8125
- NPI assigned
- Apr 17, 2006
- Organization subpart
- No
Authorized official
- Name
- Mary Pat Houlihan
- Title
- Director
- Phone
- (847) 374-8100
Practitioners 2
-
Jay L. Korach, M.D.
-
Thomas A Predey, MD
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician |
2085R0202X | IL | Yes |
Addresses
Primary practice location
2101 Waukegan Rd
Suite 108
Bannockburn, IL 60015-1836
Mailing address
2101 Waukegan Rd
Suite 108
Bannockburn, IL 60015-1836
Phone (847) 374-8100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04932007 | Other | IL | BLUE SHIELD |
| CK4071 | Other | IL | RAILROAD MEDICARE |
Other names
- OPEN ADVANCED MRI OF DEERFIELD, LLC
Other providers in Bannockburn, IL
- 1918 Winter Street Operating Co LLC
- 24/7 Brightstar Operations, LLC
- Activecare Network, LLC
- Malka Adler
- Amy Alcorn
- Jay H Alexander
- Brian J Allen
- Amen Clinics, Inc Chicago
- Ammirati Counseling
All providers in Bannockburn, IL · Diagnostic Radiology Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. 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.