HALES CORNERS MRI, LLC (NPI# 1336195304) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336195304 |
| Entity Type | Organization |
| Organization Name | HALES CORNERS MRI, LLC |
| Practice Address |
11035 W Forest Home Ave Suite 118 Hales Corners WI 53130-2541 |
| Mailing Address |
1616 E Roosevelt Rd Suite 5 Wheaton IL 60187-6850 |
| Practice Telephone | 4145259000 |
| Practice Fax Number | 4145259070 |
| Mailing Telephone | 8774444540 |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2012-01-01 |
| Authorized Official Name | MR. EDWIN C. SAGE (ADMINISTRATIVE MANAGER) |
| Authorized Official Telephone | 8774444540 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities | ||
| Y | 261QM1200X |
Clinic/Center Specialization: Magnetic Resonance Imaging (MRI) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RAIL ROAD MEDICARE PIN | P00186791 | 01 | |
| WI | 32896300 | 05 |
| Street Address |
11035 W FOREST HOME AVE SUITE 118 |
| City | HALES CORNERS |
| State | WI |
| Zip Code | 53130-2541 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740257674 | Mary T Wells | Pediatrics | 11035 W Forest Home Ave, Hales Corners, WI 53130-2541 | 2006-02-28 |
| 1831545763 | Paramount Pediatric Dentistry Sc | Dentist | 11035 W Forest Home Ave, Suite116, Hales Corners, WI 53130-2541 | 2016-05-10 |
| 1790065001 | Forest View Health Center, L.L.C. | Clinic/Center | 11035 W Forest Home Ave, Hales Corners, WI 53130-2541 | 2011-08-18 |
| 1558640052 | Nathan David Berg | Audiologist | 11035 W Forest Home Ave, Suite 108, Hales Corners, WI 53130-2541 | 2011-08-15 |
| 1093008575 | Forest View Health Center, LLC | Dietary Manager | 11035 W Forest Home Ave, Hales Corners, WI 53130-2541 | 2011-05-17 |
| 1508058744 | Jennifer Lyn Burton | Psychologist | 11035 W Forest Home Ave, Hales Corners, WI 53130-2541 | 2007-08-12 |
| 1669679759 | Katherine E Damon | Physician Assistant | 11035 W Forest Home Ave, Hales Corners, WI 53130-2541 | 2007-07-02 |
| 1568664894 | S J Millen, Md.sc | Audiologist | 11035 W Forest Home Ave, Suite 108, Hales Corners, WI 53130-2541 | 2007-05-31 |
| 1720298789 | Richard Edward Brigham | Psychologist | 11035 W Forest Home Ave, Suite 122, Hales Corners, WI 53130-2541 | 2007-05-22 |
| 1760697973 | Lori Jean Olszewski | Audiologist | 11035 W Forest Home Ave, Suite 108, Hales Corners, WI 53130-2541 | 2007-05-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962995563 | Leo A Levesque IIi | Chiropractor | Chiro One Wellness Center of Hales Corners LLC, 5305 S 108th St, Hales Corners, WI 53130 | 2018-06-08 |
| 1730512286 | Rebecca Lynn Gnas | Chiropractor | 10731 W. Forest Home Avenue, Hales Corners, WI 53130 | 2013-08-19 |
| 1316097843 | Michael S. Kotkin | Psychologist | 9415 W. Forest Home Ave. Suite 104, Hales Corners, WI 53130 | 2007-01-10 |
| 1588713705 | Dennis Keith Wolf | Social Worker | 12065 W Janesville Road, Hales Corners, WI 53130 | 2007-01-09 |
| 1124186978 | Briar House Facility Lpc Briar I | Assisted Living Facility | 10133 W Brookside Dr, Hales Corner, WI 53130 | 2006-12-05 |
| 1598837171 | Gilbert Jerome Brickler | Dentist | 6080 South 108th St, Suite 111 Gilbert J Brickler Dds, Hales Corners, WI 53130 | 2006-11-15 |
| 1306957840 | Donald Allen Whitlock | Dentist | 11035 W. Forest Home Ave, #116, Hales Corners, WI 53130 | 2006-08-31 |
| 1528074309 | James C. Boudreau, Dpm, Sc | Podiatrist | 6191 S. 108th St., Hales Corners, WI 53130 | 2006-07-31 |
| 1912441437 | Katheryn Elizabeth Hurst | Physical Therapist | 5764 S 108th St, Hales Corners, WI 53130 | 2016-12-19 |
| 1417115700 | Richard Anthony Mueller | Dentist | 11801 W Janesville Rd, Hales Corners, WI 53130 | 2008-05-23 |
| Find all providers in zip 53130 | ||||
| Taxonomy Code | 261QM1200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Magnetic Resonance Imaging (MRI) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114563707 | Bellin Memorial Hospital Inc | Clinic/Center | 1241 Lombardi Access Rd Ste H, Green Bay, WI 54304-4059 | 2019-11-19 |
| 1457918781 | Smart Choice Mri LLC | Clinic/Center | 1580 Heritage Blvd, West Salem, WI 54669-9418 | 2019-05-22 |
| 1225407075 | Smart Choice Mri, LLC | Clinic/Center | 3525 E Calumet St Ste 1500, Appleton, WI 54915-4181 | 2015-09-23 |
| 1356397616 | Newisconsin Mri Center of Green Bay LLC | Clinic/Center | 2141 Lime Kiln Rd, Green Bay, WI 54311-6215 | 2006-05-26 |
| 1518920883 | Bellin Memorial Hospital Inc | Clinic/Center | 740 S Vanburen St, Green Bay, WI 54301 | 2006-04-08 |
| 1457356321 | West Bend Open Mri, LLC | Clinic/Center | 1016 Gateway Ct, West Bend, WI 53095-8541 | 2005-06-16 |
| 1841293552 | Eauclaire Open Mri, LLC | Clinic/Center | 4130 State Road 93, Eau Claire, WI 54701-7806 | 2005-05-27 |
| 1881697837 | Fox Valley Open Mri, LLC | Clinic/Center | 201 W Northland Ave, Appleton, WI 54911-2039 | 2005-05-23 |
| 1992268262 | Smart Choice Mri LLC | Clinic/Center | 1716 Lawrence Dr, De Pere, WI 54115-9108 | 2019-04-12 |
| 1548713506 | Smart Choice Mri, LLC | Clinic/Center | 10532 N Port Washington Rd, Suite 1b, Mequon, WI 53092-5563 | 2016-07-26 |
| Find all providers with the same taxonomy | ||||
| City | HALES CORNERS |
| Zip Code | 53130 |
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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.