Provider Demographics
NPI:1215429501
Name:THE OPEN MRI CENTER
Entity type:Organization
Organization Name:THE OPEN MRI CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LANA
Authorized Official - Middle Name:DILLARD
Authorized Official - Last Name:YOUSSEF
Authorized Official - Suffix:
Authorized Official - Credentials:BS, RVT, RDMS
Authorized Official - Phone:618-252-8336
Mailing Address - Street 1:112 E CLARK ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:IL
Mailing Address - Zip Code:62946-2703
Mailing Address - Country:US
Mailing Address - Phone:618-926-5808
Mailing Address - Fax:618-988-8852
Practice Address - Street 1:3123 WILLIAMSON COUNTY PKWY
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IL
Practice Address - Zip Code:62959-5235
Practice Address - Country:US
Practice Address - Phone:618-998-8850
Practice Address - Fax:618-998-8852
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CT SCAN CENTER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-06-01
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty