Ft. Jesse Imaging Center LLC
Ft. Jesse Imaging Center LLC is a healthcare organization registered as Radiology Clinic/Center in Normal, IL, holding Type 2 (organization) NPI 1245287143 since 2006. The authorized official on file is Amy Stout, President/Ceo.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1245287143 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Ft. Jesse Imaging Center LLC |
| Practice address | 2200 FORT JESSE RD, SUITE 130, Normal, IL, 61761 |
| Phone | 3094545552 |
| Fax | 3094545452 |
| Enumeration date | 2006-05-27 |
| Last updated in NPPES | 2025-12-16 |
Authorized official
| Name | Amy Stout |
|---|---|
| Title | President/Ceo |
| Phone | 6152612306 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 261QR0206X | Mammography Clinic/Center | Secondary | 9256804 | IL |
| 2085R0202X | Diagnostic Radiology Physician | Secondary | — | — |
| 261QR0200X | Radiology Clinic/Center | Primary | 9256804 | IL |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 46015604001 | Medicaid | IL | — |
Copy-ready billing details
Provider: Ft. Jesse Imaging Center LLC NPI: 1245287143 Taxonomy: 261QR0200X (Radiology Clinic/Center) Address: 2200 FORT JESSE RD, SUITE 130, Normal, IL, 61761
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1164419818 | Lawrence Li | Individual | Orthopaedic Surgery Physician | Normal, IL |
| 1144217472 | Nancy Davis | Individual | Anesthesiology Physician | Normal, IL |
| 1730165747 | Jill Henry | Individual | Certified Registered Nurse Anesthetist | Normal, IL |
| 1730165762 | Catherine Gleason-Dintaman | Individual | Certified Registered Nurse Anesthetist | Normal, IL |
| 1104802966 | Sabita Reddy | Individual | Pain Medicine (Anesthesiology) Physician | Normal, IL |
| 1558348599 | Juanita Smith | Individual | Certified Registered Nurse Anesthetist | Normal, IL |
| 1881672582 | Lisa Russell | Individual | Certified Registered Nurse Anesthetist | Normal, IL |
| 1629043385 | Margaret Starr | Individual | Licensed Practical Nurse | Normal, IL |
Verify this record
Cross-check NPI 1245287143 against the authoritative CMS record: view Ft. Jesse Imaging Center LLC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
How current is this record?
Where is Ft. Jesse Imaging Center LLC located?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2025-12-16.