Midway Diagnostic Center LTD

Primary specialty

Legal MedicineTaxonomy code 173000000X

Legal business name

MIDWAY DIAGNOSTIC CENTER LTD

Practice address

5261 S Cicero Ave
Chicago, IL 60632-4915

Phone

(773) 585-7508

NPI assigned

Jun 7, 2006

Organization subpart

No

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

Authorized official

Name

Bohdan Fedirko

Title

President

Phone

(773) 585-7505

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195084800000",
    "number": "1033159090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5261 S CICERO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606324915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5261 S CICERO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606324915",
            "telephone_number": "773-585-7508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWAY DIAGNOSTIC CENTER LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2007-11-15",
        "status": "A",
        "authorized_official_last_name": "FEDIRKO",
        "authorized_official_first_name": "BOHDAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-585-7505"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Legal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Legal Medicine in Chicago, IL
• Providers in Chicago, IL by specialty
• Legal Medicine in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.