4365 ARCHER MRI, LLC (NPI# 1265765218) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265765218 |
| Entity Type | Organization |
| Organization Name | 4365 ARCHER MRI, LLC |
| Other Organization Name | ARCHER OPEN MRI |
| Practice Address |
4365 South Archer Avenue Chicago IL 60632 |
| Mailing Address |
Po Box 7389 Prospect Heights IL 60070-7389 |
| Practice Telephone | 7732991071 |
| Practice Fax Number | 7732991074 |
| Mailing Telephone | 8478703600 |
| Mailing Fax Number | 8473703500 |
| Enumeration Date | 2009-09-09 |
| Last Update Date | 2009-09-09 |
| Authorized Official Name | DR. MARVIN E. TAZELAAR (MANAGER) |
| Authorized Official Telephone | 7732991071 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0200X |
Clinic/Center Specialization: Radiology |
1959633 | IL | Ambulatory Health Care Facilities |
| Y | 261QM1200X |
Clinic/Center Specialization: Magnetic Resonance Imaging (MRI) |
1959633 | IL | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Archer Open MRI | Doing Business As Name - Organization |
| Street Address |
4365 SOUTH ARCHER AVENUE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60632 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104474790 | Amanda Rose Dirnberger | Nurse Practitioner | 3229-43 W. 47th Pl., Chicago, IL 60632 | 2019-08-28 |
| 1982121042 | Brown Archer Dental PC | Dentist | 4893 S Archer Ave, Chicago, IL 60632 | 2017-08-29 |
| 1538577085 | Metrosmiles - Archer Heights Dental | Dentist | 5141 S Cicero Ave, Chicago, IL 60632 | 2014-07-29 |
| 1174955173 | Thresholds | Community/Behavioral Health | 718-24 West 47th St, Chicago, IL 60632 | 2013-08-01 |
| 1659612570 | Sapex Home Healthcare, Inc. | In Home Supportive Care | 4107 West 47th Street, Chicago, IL 60632 | 2013-03-04 |
| 1912275462 | Dawn Marie Mackessy | Pharmacist | 5435 S. Kedzie Ave, Chicago, IL 60632 | 2011-12-12 |
| 1033494752 | Molly Elizabeth Mcdermott | Pharmacist | District 222-walgreens, Chicago, IL 60632 | 2011-10-13 |
| 1780908434 | Chicago Electrical Trauma Research Institute | Specialist/Technologist, Other | 4047 W. 40th Street, Chicago, IL 60632 | 2010-03-24 |
| 1295968121 | Smile Lee Faces | Dentist | 4197 S Archer Ave, Chicago, IL 60632 | 2009-08-26 |
| 1578791158 | Visionworks, Inc. | Eyewear Supplier (Equipment, not the service) | 4313 S. Pulaski, Chicago, IL 60632 | 2009-06-23 |
| Find all providers in zip 60632 | ||||
| Taxonomy Code | 261QM1200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Magnetic Resonance Imaging (MRI) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326516584 | Loretto Hospital | Clinic/Center | 7431 S East End Ave, Floor 1st Suite 2, Chicago, IL 60649-3611 | 2018-11-06 |
| 1205379229 | Fulton Market Mri LLC | Clinic/Center | 559 W Kinzie St, Chicago, IL 60654-5702 | 2016-11-22 |
| 1922461664 | Smart Choice Mri, LLC | Clinic/Center | 1850 N Clybourn Ave, Chicago, IL 60614-8048 | 2016-03-31 |
| 1881954311 | Chicago Upright Mri, LLC | Clinic/Center | 22 N Morgan St, Unit 105, Chicago, IL 60607-2606 | 2012-05-17 |
| 1821045659 | Edgebrook Radiology Management | Clinic/Center | 5320 W Devon Ave, Chicago, IL 60646-4108 | 2006-05-27 |
| 1316949886 | Premier Health Services, Inc | Clinic/Center | 559 West Kinzie, Chicago, IL 60654 | 2005-08-13 |
| 1255732061 | Highpoint Open Mri of Chicago, LLC | Clinic/Center | 3855 N Cicero Ave, Chicago, IL 60641-3623 | 2014-09-11 |
| 1669881686 | Molecular Imaging Chicago LLC | Clinic/Center | 4351 N Cicero Ave, Chicago, IL 60641-1502 | 2014-08-04 |
| 1982014064 | Mayfair Advantage Mri, Inc | Clinic/Center | 4351 N Cicero Ave, Chicago, IL 60641-1502 | 2014-04-29 |
| 1881027860 | Illinois Imaging, Inc. | Clinic/Center | 4044 N Lincoln Ave, Suite 377, Chicago, IL 60618-3038 | 2013-08-14 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.