ILLINI MRI LLC (NPI# 1528013422) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528013422 |
| Entity Type | Organization |
| Organization Name | ILLINI MRI LLC |
| Practice Address |
801 Illini Dr Silvis IL 61282-1804 |
| Practice Telephone | 3097929363 |
| Practice Fax Number | 5634213419 |
| Mailing Telephone | 3097929363 |
| Mailing Fax Number | 5634213419 |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | MR. CHARLES E BRUHN (CEO) |
| Authorized Official Telephone | 3097924265 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
========= | IL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS ILLINOIS | 0813286 | 01 |
| HEALTHLINK | 634002 | 01 | |
| IA | IOWA BLUE CROSS | 90359 | 01 |
| IL | JOHN DEERE HEALTHCARE | IL0100 | 01 |
| Street Address |
801 ILLINI DR |
| City | SILVIS |
| State | IL |
| Zip Code | 61282-1804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245224310 | Leighton V Arcenas | Internal Medicine | 801 Illini Dr, Silvis, IL 61282-1804 | 2005-09-06 |
| 1215550066 | Ndieme Ndoye | Nurse Practitioner | 801 Illini Dr, Silvis, IL 61282-1804 | 2020-05-27 |
| 1558996942 | Marceline Kougbani-sebou | Nurse Practitioner | 801 Illini Dr, Silvis, IL 61282-1804 | 2020-03-06 |
| 1417417650 | Nichole R Schold | Nurse Practitioner | 801 Illini Dr, Silvis, IL 61282-1804 | 2019-03-22 |
| 1023529252 | Payal Shah | Physician Assistant | 801 Illini Dr, Silvis, IL 61282-1804 | 2017-10-16 |
| 1295254175 | Ian Hart | Physician Assistant | 801 Illini Dr, Silvis, IL 61282-1804 | 2017-09-12 |
| 1376922930 | Muhammad Kumail Shah | Family Medicine | 801 Illini Dr, Silvis, IL 61282 | 2015-05-28 |
| 1104268622 | Pathsource Diagnostics, LLC | Pathology | 801 Illini Dr, Silvis, IL 61282-1804 | 2013-07-25 |
| 1144596743 | Samir M Mahfouz | Anesthesiology | 801 Illini Dr, Silvis, IL 61282-1804 | 2012-03-28 |
| 1164721429 | Heng Wu | Anesthesiology | 801 Illini Dr, Silvis, IL 61282-1804 | 2011-03-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174172605 | Phyllis Cunningham | Technician | 603 2nd Ave C, Silvis, IL 61282 | 2019-09-07 |
| 1710369400 | Krystle Lee Hergert | Dietitian, Registered | 2001 5th Street, Silvis, IL 61282 | 2015-06-18 |
| 1558549469 | Bobb Chiropractic Center P.C. | Chiropractor | 813 1st Avenue, Silvis, IL 61282 | 2008-02-01 |
| 1952509846 | Jennifer Marie Jensen | Pharmacist | 1601 18th St, Silvis, IL 61282 | 2007-07-03 |
| 1871516781 | Joseph R Yates | Emergency Medicine | 801 Illini Drive, Silvis, IL 61282 | 2006-07-25 |
| 1376581447 | Holly S Wilkinson | Physical Therapist | 902 Illini Drive, Silvis, IL 61282 | 2006-06-02 |
| 1831145507 | American Drug Stores LLC | Durable Medical Equipment & Medical Supplies | 1312 John Deere Expy, Silvis, IL 61282 | 2006-05-25 |
| 1194326017 | Paul Garner | Pharmacist | 2001 5th St, Silvis, IL 61282 | 2020-11-06 |
| 1366043291 | Karen Marie Garner | Pharmacist | 2001 5th Street, Silvis, IL 61282 | 2020-11-06 |
| 1659865848 | Njl Chiropractic | Clinic/Center | 813 1st Ave, Silvis, IL 61282 | 2018-06-20 |
| Find all providers in zip 61282 | ||||
| Taxonomy Code | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073681318 | Genesis Health System | Clinic/Center | 801 Illini Dr, Silvis, IL 61282-1804 | 2006-12-04 |
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|---|---|---|---|---|
| 1043831134 | St Anthony's Memorial Hospital of The Hospital Sisters of The Third Or | Clinic/Center | 101 Coles Centre Pkwy, Ste 101, Mattoon, IL 61938 | 2020-04-30 |
| 1285255463 | Blessing Corporate Services, Inc | Clinic/Center | 927 Broadway St Ste 132, Quincy, IL 62301-2737 | 2020-04-29 |
| 1518505585 | Akumin Health Illinois, LLC | Clinic/Center | 820 E Terra Cotta Ave Ste 136, Crystal Lake, IL 60014-3650 | 2019-12-20 |
| 1992349724 | Home Diagnostics Plus LLC | Clinic/Center | 2154 W Rosemont Ave Ste 2f, Chicago, IL 60659-3226 | 2019-11-05 |
| 1639731839 | United Providers Inc | Clinic/Center | 9325 S Thomas Ave, Bridgeview, IL 60455-2163 | 2019-07-08 |
| 1861957144 | Rsr Medical | Clinic/Center | 1509 N Western Ave Unit 404, Chicago, IL 60622-1747 | 2019-01-31 |
| 1013429125 | Diagnostic Services LLC | Clinic/Center | 16101 Weber Rd Unit A, Crest Hill, IL 60403-8813 | 2017-10-30 |
| 1285157313 | Midwest Advanced Radiology Center, LLC | Clinic/Center | 11600 S Kedzie Ave Ste G, Merrionette Park, IL 60803-6308 | 2017-07-20 |
| 1063960276 | Mars Healthcare LLC | Clinic/Center | 721 W Highway 22nd, Lake Zurich, IL 60047 | 2016-09-16 |
| 1922456474 | Berwyn Imaging LLC | Clinic/Center | 6728 Cermak Rd, Berwyn, IL 60402-2217 | 2016-05-25 |
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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.