OrganizationActive
Ft. Jesse Imaging Center LLC
NPI 1245287143 · Radiology Clinic/Center · Normal, IL
Provider details
- NPI number
- 1245287143
- Entity type
- Organization
- Primary specialty
- Radiology Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Amy Stout, President/Ceo(615) 261-2306
- License
- 9256804 (IL)
Specialties & taxonomies
Ambulatory Health Care Facilities
Ambulatory Health Care Facilities
- Diagnostic Radiology Physician2085R0202X
Allopathic & Osteopathic Physicians
Practice location
2200 Fort Jesse Rd
Suite 130
Normal, IL 61761-6286
Phone: (309) 454-5552
Fax: (309) 454-5452
Approximate (ZIP-level) locationGet directions
Mailing address
2200 Fort Jesse Rd
Normal, IL 61761-6286
Registry dates
- Enumerated
- 2006-05-27
- Last updated
- 2025-12-16
- Certified
- 2025-12-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.