FOREST CITY DIAGNOSTIC IMAGING LLC NPI 1386755700

NPI Information

FOREST CITY DIAGNOSTIC IMAGING LLC is a radiology clinic center in Rockford, IL. FOREST CITY DIAGNOSTIC IMAGING LLC NPI is 1386755700. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Rockford Open Mri, L.l.c..

The provider's business location address is:

735 N PERRYVILLE RD
ROCKFORD, IL
ZIP 61107-200
Phone: (815) 398-1300
Fax: (815) 398-3797

The provider's authorized official is Patricia A Wabick .
The authorized official title is Manager and has the following contact phone number (708) 675-1500.

The CLIA number assigned to this NPI record is 14D1072296 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/31/2006 and was last updated on 6/12/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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