BERWYN IMAGING LLC (NPI# 1922456474) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922456474 |
| Entity Type | Organization |
| Organization Name | BERWYN IMAGING LLC |
| Other Organization Name | WESTERN OPEN MRI |
| Practice Address |
6728 Cermak Rd Berwyn IL 60402-2217 |
| Practice Telephone | 7087888900 |
| Practice Fax Number | 7087885110 |
| Mailing Telephone | 7087888900 |
| Mailing Fax Number | 7087885110 |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2016-10-19 |
| Authorized Official Name | MARVIN TAZELAAR (DIRECTOR) |
| Authorized Official Telephone | 6303334674 |
| 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 |
|---|---|---|---|
| IL | TELEPHONE | 7087888900 | 01 |
| Other Name | Type Code |
|---|---|
| WESTERN OPEN MRI | Doing Business As Name - Organization |
| Street Address |
6728 CERMAK RD |
| City | BERWYN |
| State | IL |
| Zip Code | 60402-2217 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720539646 | Berwyn Diagnostic Imaging LLC | Clinic/Center | 6728 Cermak Rd, Berwyn, IL 60402-2217 | 2016-10-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619586518 | Lisa K Anderson-shaw | Clinical Ethicist | Macneal Trinity Medical Cetner, 3249 Oak Park Avenue, Berwyn, IL 60402 | 2020-07-27 |
| 1922622380 | Ayesha Ikram | Internal Medicine | Macneal Hospital 3249 S. Oak Park Ave, Brewyn, IL 60402 | 2020-06-02 |
| 1598329146 | Eleanor Teoh | Student in an Organized Health Care Education/Training Program | Family Medicine, Macneal Family Medicine Center, 3231 Eucild Ave, 5th Floor, Berwyn, IL 60402 | 2019-04-30 |
| 1376013920 | Virginia Mireles | Behavior Technician | 2317 S. Home, Berwyn, IL 60402 | 2018-11-27 |
| 1245709047 | Saraswati Koirala | Dentist | 1227 S Harlem Ave Apt414, Berwyn, IL 60402 | 2018-11-21 |
| 1295204220 | Dental Town Ltd | Dentist | 7106 W Cermak Rd, Berwyn, IL 60402 | 2018-11-20 |
| 1396231684 | Toya M Gildart | Counselor | Pillars, 6415 Stanley Avenue, Berwyn, IL 60402 | 2018-07-10 |
| 1437655685 | Ana Luisa Desantiago | Social Worker | 3245 Grove Ave Ste 201, Berwyn, IL 60402 | 2018-04-04 |
| 1821520198 | Chetan Velagapudi | Student in an Organized Health Care Education/Training Program | 3231 S Euclid Avenue, Suite 203, Berwyn, IL 60402 | 2017-03-28 |
| 1174976567 | Sydney Talavera | Counselor | 6415 Stanley Ave., Berwyn, IL 60402 | 2016-07-20 |
| Find all providers in zip 60402 | ||||
| Taxonomy Code | 261QM1200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Magnetic Resonance Imaging (MRI) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831342369 | Vhs of Illinois Inc | Clinic/Center | 3345 Oak Park Ave, Berwyn, IL 60402-3434 | 2008-10-28 |
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| 1295385284 | St. Elizabeth's Hospital of The Hospital Sisters of The Third Order | Clinic/Center | 1512 N Green Mount Rd Ste 103, O Fallon, IL 62269-2083 | 2019-09-12 |
| 1326516584 | Loretto Hospital | Clinic/Center | 7431 S East End Ave, Floor 1st Suite 2, Chicago, IL 60649-3611 | 2018-11-06 |
| 1164969838 | Smart Choice Mri, LLC | Clinic/Center | 850 N Milwaukee Ave Ste 103, Vernon Hills, IL 60061-1553 | 2017-01-19 |
| 1417491655 | Smart Choice Mri LLC | Clinic/Center | 757 E Boughton Rd, Bolingbrook, IL 60440-2281 | 2016-12-07 |
| 1205379229 | Fulton Market Mri LLC | Clinic/Center | 559 W Kinzie St, Chicago, IL 60654-5702 | 2016-11-22 |
| 1477003267 | Smart Choice Mri, LLC | Clinic/Center | 2752 Us Highway 34, Oswego, IL 60543 | 2016-10-05 |
| 1104376987 | Smart Choice Mri, LLC | Clinic/Center | 2830 S Highland Ave Unit 9, Lombard, IL 60148-7135 | 2016-10-05 |
| 1922461664 | Smart Choice Mri, LLC | Clinic/Center | 1850 N Clybourn Ave, Chicago, IL 60614-8048 | 2016-03-31 |
| 1144695511 | Smart Choice Mri, LLC | Clinic/Center | 3560 Touhy Avenue, Skokie, IL 60076-6218 | 2015-12-10 |
| 1598130635 | Smart Choice Mri LLC | Clinic/Center | 1406 N Meacham Rd, Schaumburg, IL 60173-4808 | 2015-12-01 |
| Find all providers with the same taxonomy | ||||
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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.