Bloomingdale Open MRI, LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

BLOOMINGDALE OPEN MRI, LLC

Practice address

303 E Army Trail Rd
Suite 110
Bloomingdale, IL 60108-2169

Phone

(630) 529-9400

Fax

(630) 529-9401

NPI assigned

Jul 7, 2006

Last updated

Jan 11, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Edwin C Sage

Title

Member Manager

Phone

(877) 444-4540

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326240000000",
    "number": "1891727988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 E ROOSEVELT RD",
            "address_2": "SUITE 5",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601876850",
            "telephone_number": "877-444-4540",
            "fax_number": "847-550-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 E ARMY TRAIL RD",
            "address_2": "SUITE 110",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082169",
            "telephone_number": "630-529-9400",
            "fax_number": "630-529-9401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOMINGDALE OPEN MRI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2012-01-11",
        "status": "A",
        "authorized_official_last_name": "SAGE",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "877-444-4540",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Radiology Clinic/Center in Bloomingdale, IL
• Providers in Bloomingdale, IL by specialty
• Radiology Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; 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.