| Organization Name: | SOUTHLAKE MRI & DIAGNOSTIC CENTER LLC |
| NPI Number: | 1134178148 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RAMAN CHOPRA (PRINCIPAL) |
| Mailing Address: | 108 E 90th Dr Merrillville |
| State: | IN US |
| Postal Code: | 464107160 |
| Phone Number: | 2197951801 |
| Fax Number: | 2197951802 |
| NPI Enumeration Date: | 05/08/2006 |
| NPI Last Update Date: | 02/06/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |