Individual provider Active NPI

Najma A. Mirza, M.D.

  • Diagnostic Radiology Physician
  • Skokie, IL
National Provider Identifier
1043250053
Registry record updated Sep 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036057254 Issued in IL
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

Updated by the provider on Sep 20, 2012

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
036057254MedicaidIL

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

LicenseStateTypeSpecialty
036057254ILMDDiagnostic Radiology Physician
L2124242MIMDDiagnostic Radiology Physician
M11728002MIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.