NPIMap

Organization Active NPI

Minimally Invasive Therapy Partners S.C.

  • Radiology Clinic/Center
  • Chicago, IL
National Provider Identifier
1053659052
Registry record updated Nov 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
MINIMALLY INVASIVE THERAPY PARTNERS S.C.
Doing business as
Mobile Intervention and Diagnostic
Practice address
660 W Wayman St
Unit 204 B
Chicago, IL 60661-1296
Phone
(844) 834-6362
Fax
(855) 497-2932
NPI assigned
Jan 25, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2016

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

Authorized official

Name
Dr. Iftikhar Ahmad, M.D.
Title
President
Phone
(844) 834-6362

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Infusion Therapy Clinic/Center 261QI0500X
Medical Specialty Clinic/Center 261QM2500X
Radiology Clinic/Center 261QR0200X Primary
Mobile Radiology Clinic/Center 261QR0208X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 335V00000X

Addresses

Primary practice location

660 W Wayman St
Unit 204 B
Chicago, IL 60661-1296

Mailing address

5011 N Lincoln Ave
Chicago, IL 60625-6351
Phone (844) 834-6362

Other names 1

  • Mobile Intervention and Diagnostic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Minimally Invasive Therapy Partners SC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5011 N Lincoln Ave
#204B
Chicago, IL 60625
Phone (844) 834-6362

NPI Registry JSON

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

{
    "created_epoch": "1359072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479340800000",
    "number": "1053659052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5011 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606256351",
            "telephone_number": "844-834-6362",
            "fax_number": "708-489-7989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 W WAYMAN ST",
            "address_2": "UNIT 204 B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606611296",
            "telephone_number": "844-834-6362",
            "fax_number": "855-497-2932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINIMALLY INVASIVE THERAPY PARTNERS S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-25",
        "last_updated": "2016-11-17",
        "status": "A",
        "authorized_official_last_name": "AHMAD",
        "authorized_official_first_name": "IFTIKHAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "844-834-6362",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mobile Intervention and Diagnostic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2016; 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.