Provider Demographics
NPI:1306890306
Name:EXTREMITY MRI SPECIALISTS INC
Entity type:Organization
Organization Name:EXTREMITY MRI SPECIALISTS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SYED
Authorized Official - Middle Name:
Authorized Official - Last Name:TIRMIZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-876-1600
Mailing Address - Street 1:1887 N NELTNOR BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60185-5932
Mailing Address - Country:US
Mailing Address - Phone:630-876-1600
Mailing Address - Fax:630-876-1604
Practice Address - Street 1:1887 N NELTNOR BLVD
Practice Address - Street 2:
Practice Address - City:WEST CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60185-5932
Practice Address - Country:US
Practice Address - Phone:630-876-1600
Practice Address - Fax:630-876-1604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02232665OtherBLUESHIELD GROUP NUMBER
ILDD6699OtherRAILROAD MEDICARE GROUP #
ILDD6699OtherRAILROAD MEDICARE GROUP #