Division MRI, Inc.

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

DIVISION MRI, INC.

Practice address

2618 W Division St
Chicago, IL 60622-7107

Phone

(773) 235-7455

Fax

(773) 235-7055

NPI assigned

Mar 30, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Amer Rustum, MD

Title

Owner/President

Phone

(773) 456-3384

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1238371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262822400000",
    "number": "1780826230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 220450",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606220450",
            "telephone_number": "773-235-7455",
            "fax_number": "773-235-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2618 W DIVISION ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606227107",
            "telephone_number": "773-235-7455",
            "fax_number": "773-235-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVISION MRI, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-30",
        "last_updated": "2010-01-07",
        "status": "A",
        "authorized_official_last_name": "RUSTUM",
        "authorized_official_first_name": "AMER",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "773-456-3384",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physiological Laboratory in Chicago, IL
• Providers in Chicago, IL by specialty
• Physiological Laboratory in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2010; 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.