NPIMap

Organization Active NPI

Inner-City Muslim Action Network

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
National Provider Identifier
1003244567
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
INNER-CITY MUSLIM ACTION NETWORK
Practice address
2744 W 63Rd St
Chicago, IL 60629-2343
Phone
(773) 434-4626
Fax
(773) 776-3623
NPI assigned
Oct 21, 2013
Last updated
Jun 17, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Syeda Kamran
Title
Interim Board Chair
Phone
(773) 434-4626

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Public Health & General Preventive Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083P0901X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

2744 W 63Rd St
Chicago, IL 60629-2343

Mailing address

2744 W 63Rd St
Chicago, IL 60629-2343
Phone (773) 434-4626

Other practice location 1

2749 W 63rd St
Chicago, IL 60629-2342
Phone (773) 434-4626

Other names 1

  • IMAN Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150421001140 IL Part B Supplier - Clinic/Group Practice 4183942212 Receives reassigned benefits from 24 practitioners
1 other NPI on this enrollment
Practice locations: Chicago, IL
O20181001002720 IL Part A Provider - Federally Qualified Health Center (FQHC) 4183942212 Practice locations: Chicago, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003244567. Details of each certification follow.

Federally qualified health center certification: CCN 781915

Legal name
INNER-CITY MUSLIM ACTION NETWORK
Doing business as
IMAN
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 2, 2018
Last certification
Oct 2, 2018
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 1, 1999 in IL
Enrollment address
2744 W 63Rd St
Chicago, IL 60629-2343

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Harriet Lewis Individual OtherSenior Director Jan 27, 2013
Sean Burke Individual Operational/Managerial ControlDirector of Health Apr 1, 2018
Maysoon Haleem Individual W-2 Managing EmployeeHealth Center Oct 1, 2015
Zubair Tajuddin Individual Corporate OfficerBoard Secretary Jan 1, 2012
Chris Carter Individual Corporate OfficerBoard Chair Jan 1, 2006
Clyde El-Amin Individual Corporate OfficerCo Board Chair Jan 1, 2003
Feroz Patel Individual Corporate OfficerBoard Tresurer Jan 1, 2014
Rami Nashasshibi Individual Corporate DirectorExecutive Director Jan 22, 1997 100%

Practitioners & affiliated clinicians

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 28

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1382313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781654400000",
    "number": "1003244567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2744 W 63RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606292343",
            "telephone_number": "773-434-4626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2744 W 63RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606292343",
            "telephone_number": "773-434-4626",
            "fax_number": "773-776-3623"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2749 W 63rd St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606292342",
            "country_code": "US",
            "telephone_number": "773-434-4626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INNER-CITY MUSLIM ACTION NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-21",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A",
        "authorized_official_last_name": "KAMRAN",
        "authorized_official_first_name": "SYEDA",
        "authorized_official_title_or_position": "INTERIM BOARD CHAIR",
        "authorized_official_telephone_number": "773-434-4626"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IMAN",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "IMAN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.