ILLINOIS MEDICAL GROUP SC NPI 1649219007

NPI Information

NPI: 1649219007
Provider Name: ILLINOIS MEDICAL GROUP SC
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
4211 N CICERO AVE
CHICAGO, IL
ZIP 60641
Phone: (773) 545-6900
Get Directions

ILLINOIS MEDICAL GROUP SC is a multi-specialty clinic center in Chicago, IL. ILLINOIS MEDICAL GROUP SC NPI is 1649219007. The provider is registered as an organization entity type.

The provider's business location address is:

4211 N CICERO AVE
CHICAGO, IL
ZIP 60641-651
Phone: (773) 545-6900
Fax: (773) 685-2481

The provider's authorized official is Sarmed G Elias .
The authorized official title is President and has the following contact phone number (773) 545-6900.

The enumeration date for this NPI number is 6/4/2006 and was last updated on 6/12/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty	042618822	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	213734	MEDICARE PIN	ILLINOIS
2	DG1734	OTHER	ILLINOIS	MEDICARE RAILROAD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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