Contract Details
Midwest Open MRI
Facility name
Midwest Open MRI
Provider ID
P000005339
NPI
1780814061
Tax ID
364230399
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
321 North York Rd
Elmhurst, IL 60126
United States
County
DuPage
Phone
6302794700 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address