Active NPI
Najma A. Mirza, M.D.
- Diagnostic Radiology Physician
- Skokie, IL
National Provider Identifier
1043250053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 036057254
- Practice address
- 3701 Jarvis Ave
Skokie, IL 60076-4019 - Phone
- (847) 626-0800
- Fax
- (847) 626-0819
- NPI assigned
- Jun 7, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 036057254 | IL | Primary |
| Diagnostic Radiology Physician | 2085R0202X | 01067863A | IN | |
| Diagnostic Radiology Physician | 2085R0202X | L2124242 | MI | |
| Diagnostic Radiology Physician | 2085R0202X | M11728002 | MI |
Addresses
Primary practice location
3701 Jarvis Ave
Skokie, IL 60076-4019
Mailing address
14 Chatham LN
Oak Brook, IL 60523-2349
Phone (773) 544-9912
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036057254 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036057254 | IL | MD | Diagnostic Radiology Physician |
| L2124242 | MI | MD | Diagnostic Radiology Physician |
| M11728002 | MI | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MDS Digital Portable X-Ray Inc | Past | Accepting new patients | |
| MDS Digital Portable X-Ray Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physiological Laboratory
- West Allis, WI
- NPI 1902041502
-
- Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
- West Allis, WI
- NPI 1962523696
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348099200000",
"number": "1043250053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 CHATHAM LN",
"city": "OAK BROOK",
"state": "IL",
"postal_code": "605232349",
"telephone_number": "773-544-9912",
"fax_number": "847-626-0819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3701 JARVIS AVE",
"city": "SKOKIE",
"state": "IL",
"postal_code": "600764019",
"telephone_number": "847-626-0800",
"fax_number": "847-626-0819"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRZA",
"first_name": "NAJMA",
"middle_name": "A.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-07",
"last_updated": "2012-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "IL",
"license": "036057254",
"primary": true
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "IN",
"license": "01067863A",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MI",
"license": "L2124242",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MI",
"license": "M11728002",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036057254",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Skokie, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.