Contract Details
Advantage MRI, LLC
Facility name
Advantage MRI Waukegan
Provider ID
P000006067
Tax ID
203757444
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
1508 Grand Ave
Waukegan, IL 60085
United States
County
Lake
Phone
8472442222 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address