Organization Active NPI

Open Advanced MRI of Wheaton, LLC

  • Diagnostic Radiology Physician
  • Wheaton, IL
National Provider Identifier
1760447502
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
OPEN ADVANCED MRI OF WHEATON, LLC
Practice address
43 Danada SQ E
Wheaton, IL 60187-8484
Phone
(630) 510-7050
Fax
(630) 510-3699
NPI assigned
Apr 17, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jerry Zemela
Title
Director
Phone
(630) 510-7050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X IL Primary

Addresses

Primary practice location

43 Danada SQ E
Wheaton, IL 60187-8484

Mailing address

43 Danada SQ E
Wheaton, IL 60187-8484
Phone (630) 510-7050

Other identifiers 2

IdentifierTypeStateIssuer
02222285OtherILBLUE SHIELD
CI7538OtherILRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

43 Danada Sq E
Wheaton, IL 60189
Phone (630) 510-7050

Practitioners & affiliated clinicians

Practitioners 1

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": "1145232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760447502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 DANADA SQ E",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601878484",
            "telephone_number": "630-510-7050",
            "fax_number": "630-510-3699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 DANADA SQ E",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601878484",
            "telephone_number": "630-510-7050",
            "fax_number": "630-510-3699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN ADVANCED MRI OF WHEATON, 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": "630-510-7050"
    },
    "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": "02222285",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CI7538",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

  • 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.