Provider Demographics
NPI:1447434139
Name:PMI DIAGNOSTIC IMAGING LLC
Entity type:Organization
Organization Name:PMI DIAGNOSTIC IMAGING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:IMAGING DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MERYL
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MIONI
Authorized Official - Suffix:
Authorized Official - Credentials:RTRMR BS
Authorized Official - Phone:708-361-9852
Mailing Address - Street 1:2201 GLENWOOD AVE
Mailing Address - Street 2:PMI DIAGNOSTIC IMAGING
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-5574
Mailing Address - Country:US
Mailing Address - Phone:815-725-0006
Mailing Address - Fax:815-725-5136
Practice Address - Street 1:2201 GLENWOOD AVE
Practice Address - Street 2:PMI DIAGNOSTIC IMAGING
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-5574
Practice Address - Country:US
Practice Address - Phone:815-725-0006
Practice Address - Fax:815-725-5136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-18
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)