Provider Demographics
NPI:1023049251
Name:RAND IMAGING CENTER
Entity type:Organization
Organization Name:RAND IMAGING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HARTKE
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:847-454-2226
Mailing Address - Street 1:1051 W RAND RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-2315
Mailing Address - Country:US
Mailing Address - Phone:847-454-2226
Mailing Address - Fax:847-454-2234
Practice Address - Street 1:1051 W RAND RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-2315
Practice Address - Country:US
Practice Address - Phone:847-454-2226
Practice Address - Fax:847-454-2234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL204868Medicare ID - Type Unspecified