OPEN MRI OF SOUTHERN ILLINOIS LLC; NPI #1194710905

Contact Information

OPEN MRI OF SOUTHERN ILLINOIS LLC

2016 VADALABENE DR
MARYVILLE, IL 62062-6901

Phone: 618-288-4929
Fax: 618-288-4531
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Radiology	261QR0200X	74	Radiation Therapy Center

Indicates primary specialty

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NPI Profile & details for OPEN MRI OF SOUTHERN ILLINOIS LLC

NPI #	`1194710905`
LBN Legal business name	OPEN MRI OF SOUTHERN ILLINOIS LLC
Authorized official	STEVEN MCRAE - (MANAGING MEMBER)
Entity	Organization
Organization subpart ¹	No
Enumeration date	09/19/2005
Last updated	08/22/2020 - About 6 years ago
Identifiers	n/a

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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