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Ft. Jesse Imaging Center Llc
Diagnostic Radiology Physician in Normal, Illinois
NPI 1104333491

Ft. Jesse Imaging Center Llc is a Diagnostic Radiology Physician based in Franklin, IL and is specialized in Diagnostic Radiology. Ft. Jesse Imaging Center Llc practices in Normal, IL. The NPI Number for Ft. Jesse Imaging Center Llc is 1104333491 and holds a License No. (Illinois).

The current practice location address for Ft. Jesse Imaging Center Llc is 2200 Fort Jesse Rd, Normal, IL and can be reached out via phone at 309-454-5552.

Location: 2200 Fort Jesse Rd, Normal, IL, 37067-4652
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1104333491
Provider Name
Ft. Jesse Imaging Center Llc
Credential
Provider Entity Type
Organization
Address
2200 Fort Jesse Rd, Normal, IL, 37067-4652
Phone Number
309-454-5552
Fax Number
Provider Enumeration Date
01/08/2018
Last Update Date
11/16/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
46015604001 05 IL
institution
Provider Business Practice Location Address Details
Address
2200 Fort Jesse Rd
City
Normal
State
Illinois
Zip
61761-6286
Phone Number
309-454-5552
Fax Number
person
Provider Business Mailing Address Details
Address
2200 Fort Jesse Rd
City
Normal
State
Illinois
Zip
61761-6286
Phone Number
309-454-5552
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
2085R0202X
License No.
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Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
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