| Organization Name: | HALES CORNERS MRI, LLC |
| NPI Number: | 1336195304 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | EDWIN C. SAGE (ADMINISTRATIVE MANAGER) |
| Mailing Address: | 11035 W Forest Home Ave Suite 118 Hales Corners |
| State: | WI US |
| Postal Code: | 531302541 |
| Phone Number: | 4145259000 |
| Fax Number: | 4145259070 |
| NPI Enumeration Date: | 05/25/2006 |
| NPI Last Update Date: | 01/01/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Radiology |
| Taxonomy Definition: | |