Organization Active NPI

Presence Ambulatory Services

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Chicago, IL
National Provider Identifier
1851628630
Registry record updated May 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X
Legal business name
PRESENCE AMBULATORY SERVICES
Practice address
3101 N Harlem Ave
Chicago, IL 60634-4532
Phone
(773) 836-9360
Fax
(773) 745-5522
NPI assigned
Nov 16, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2013

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

Authorized official

Name
Mrs. Melvonne Wickliffe-Jones
Title
Credentialing MGR
Phone
(630) 914-2417

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X Primary
Radiology Clinic/Center 261QR0200X
Mammography Clinic/Center 261QR0206X

Addresses

Primary practice location

3101 N Harlem Ave
Chicago, IL 60634-4532

Mailing address

1000 Remington Blvd
Suite 100
Bolingbrook, IL 60440-0000
Phone (630) 914-2417

Other names 1

  • Resurrection Open MRI & Imaging Center Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1258329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369785600000",
    "number": "1851628630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 REMINGTON BLVD",
            "address_2": "SUITE 100",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604400000",
            "telephone_number": "630-914-2417",
            "fax_number": "630-914-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 N HARLEM AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344532",
            "telephone_number": "773-836-9360",
            "fax_number": "773-745-5522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESENCE AMBULATORY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-16",
        "last_updated": "2013-05-29",
        "status": "A",
        "authorized_official_last_name": "WICKLIFFE-JONES",
        "authorized_official_first_name": "MELVONNE",
        "authorized_official_title_or_position": "CREDENTIALING MGR",
        "authorized_official_telephone_number": "630-914-2417",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0206X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mammography",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Resurrection Open MRI & Imaging Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2013; 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.