Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ft Jesse Imaging Center LLC

Organization Diagnostic Radiology Physician · NPI 1104333491

Ft Jesse Imaging Center LLC is a Diagnostic Radiology Physician in Normal, Illinois. Registered with an NPI since 2018.

In the registry since
2018
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2200 Fort Jesse Rd
Normal, IL 61761-6286
Phone: (309) 454-5552
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X

Record details

NPI number1104333491
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Amy Stout — President/Ceo · (615) 261-2306
NPI enumeratedJanuary 8, 2018
Last updated in NPPESOctober 21, 2024
Certification dateOctober 21, 2024
Mailing address840 Crescent Centre Dr Ste 200, Franklin, TN 37067-4652

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