Active NPI
Open Advanced MRI of Wheaton, LLC
- Diagnostic Radiology Physician
- Wheaton, IL
National Provider Identifier
1760447502
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- 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, 2020
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02222285 | Other | IL | BLUE SHIELD |
| CI7538 | Other | IL | RAILROAD MEDICARE |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Diagnostic Radiology Physician
- La Grange, IL
- NPI 1568482487
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.