Provider Demographics
NPI:1144315623
Name:WESTBROOK OPEN MRI, LLC.
Entity type:Organization
Organization Name:WESTBROOK OPEN MRI, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:NELSON
Authorized Official - Last Name:MERRILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-472-8800
Mailing Address - Street 1:2000 SPRING RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1804
Mailing Address - Country:US
Mailing Address - Phone:630-472-8800
Mailing Address - Fax:
Practice Address - Street 1:3067 WOLF RD
Practice Address - Street 2:
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-5622
Practice Address - Country:US
Practice Address - Phone:708-836-9000
Practice Address - Fax:708-836-1860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1636444OtherBCBS
ILP00312639OtherRAILROAD MEDICARE PIN
IL1636444OtherBCBS