Ft. Jesse Imaging Center Llc
LBN: Ft. Jesse Imaging Center Llc
Ft. Jesse Imaging Center Llc is an health care organization with primary practice located at 2200 Fort Jesse Rd Suite 130, Normal IL 61761-6286. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Ambulatory Health Care Facilities / Radiology, Ambulatory Health Care Facilities / Radiology, Mammography. Allopathic & Osteopathic Physicians / Diagnostic Radiology is the primary health care specialty.
Ft. Jesse Imaging Center Llc can be contacted via phone (309) 454-5552, or through Hawkins, Janet via phone (309) 454-5552.
Contact Information
Primary practice address
2200 Fort Jesse Rd Suite 130
Normal IL 61761-6286
Phone: (309) 454-5552
Fax: (309) 454-5452
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | ||
| Ambulatory Health Care Facilities / Radiology | 261QR0200X | 9256804 | Illinois |
| Ambulatory Health Care Facilities / Radiology, Mammography | 261QR0206X | 9256804 | Illinois |
Profile Details
| NPI number | 1245287143 |
|---|---|
| LBN Legal business name | Ft. Jesse Imaging Center Llc |
| DBA Doing business as | |
| Authorized official | Hawkins, Janet |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 27th, 2006 |
| Last updated | Mar 16th, 2021 - about 3 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245287143 | NPPES |
| Illinois | MEDICAID | 46015604001 |
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