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Contact Information

ARCHER KEDZIE IMAGING LLC
4365 S ARCHER AVE
CHICAGO, IL60632-2826
 Phone: 773-299-1070
 Fax: 773-299-1075
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Magnetic Resonance Imaging (MRI)

261QM1200X
 

Radiology

261QR0200X 74 Radiation Therapy Center
Indicates primary specialty

NPI Profile & details for ARCHER KEDZIE IMAGING LLC

NPI Number 1881827251
LBN Legal business name ARCHER KEDZIE IMAGING LLC
Authorized official MARVIN TAZELAAR - (MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 09/01/2009
Last updated 09/01/2009 - About 17 years ago
Identifiers
IL License # 1964943
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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