Organization Active NPI

Niles Open MRI Inc

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Niles, IL
National Provider Identifier
1720211360
Registry record updated Aug 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X
Legal business name
NILES OPEN MRI INC
Practice address
8618 W Golf Rd
Niles, IL 60714-5600
Phone
(847) 824-2628
Fax
(847) 824-4157
NPI assigned
Aug 31, 2009
Last updated
Aug 31, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2009

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

Authorized official

Name
Ms. Gigy Nellamattathil
Title
Director
Phone
(847) 824-2628

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X IL Primary

Addresses

Primary practice location

8618 W Golf Rd
Niles, IL 60714-5600

Mailing address

PO Box 7389
Prospect Heights, IL 60070-7389
Phone (847) 824-2628

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120905000368 IL Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 8921255423 Practice locations: Niles, IL

National Provider Directory

National Provider Directory

Locations

8618 W Golf Rd
Niles, IL 60714
Phone (847) 824-2628

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1251676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251676800000",
    "number": "1720211360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7389",
            "city": "PROSPECT HEIGHTS",
            "state": "IL",
            "postal_code": "600707389",
            "telephone_number": "847-824-2628",
            "fax_number": "847-824-4157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8618 W GOLF RD",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607145600",
            "telephone_number": "847-824-2628",
            "fax_number": "847-824-4157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NILES OPEN MRI INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-31",
        "last_updated": "2009-08-31",
        "status": "A",
        "authorized_official_last_name": "NELLAMATTATHIL",
        "authorized_official_first_name": "GIGY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "847-824-2628",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.