Open MRI of Olympia Fields, LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

OPEN MRI OF OLYMPIA FIELDS, LLC

Practice address

3212 Vollmer Rd
Olympia Fields, IL 60461-1122

Phone

(708) 481-9800

Fax

(708) 481-9808

NPI assigned

Jun 25, 2006

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": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325376000000",
    "number": "1922034313",
    "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": "3212 VOLLMER RD",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611122",
            "telephone_number": "708-481-9800",
            "fax_number": "708-481-9808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN MRI OF OLYMPIA FIELDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2012-01-01",
        "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": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olympia Fields Family Dental
• Olympia Fields Hospital, LLC
• Olympia Fields Hospital, LLC
• Olympia Fields Hospital, LLC
• Open Mind Health Wellness
• Thomas Erastus Ortlieb Jr.
• Faizan Ali Osmani
• Emmanuel Otuwa
• Ina Pachwicewicz
• Amanda Michele Pack, PH.D.

• Radiology Clinic/Center in Olympia Fields, IL
• Providers in Olympia Fields, 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 1, 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.