Open Mri of Southern Illinois LLC

NPI #1194710905 in Maryville, Illinois

Provider Information

NPI Number: 1194710905
Entity Type: Organization
Organization Name: Open Mri of Southern Illinois LLC
Primary Specialty: Clinic/Center - Radiology
Enumeration Date: Sep 19, 2005
Last Updated: Aug 22, 2020

Practice Location

Address: 2016 VADALABENE DR
City: Maryville
State: Illinois
ZIP Code: 62062-6901
Phone: (618) 288-4929

Authorized Official

Name: MR. STEVEN MICHAEL MCRAE
Title: MANAGING MEMBER
Phone: (618) 659-1167

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Radiology — Radiology	261QR0200X	Primary

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