Interamerican Clinical Services

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

55812 Issued in IL

Legal business name

INTERAMERICAN CLINICAL SERVICES

Practice address

2651 W Division St
1St Floor
Chicago, IL 60622

Phone

(773) 252-1147

Fax

(773) 252-5938

NPI assigned

Jan 8, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Ana E Castellanos

Title

President

Phone

(773) 252-1147

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063560738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 470717",
            "address_2": "INTERAMERICAN CLINICAL SERVICES",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606470717",
            "fax_number": "773-252-5938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2651 W DIVISION ST",
            "address_2": "1ST FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60622",
            "telephone_number": "773-252-1147",
            "fax_number": "773-252-5938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERAMERICAN CLINICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CASTELLANOS",
        "authorized_official_first_name": "ANA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-252-1147",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "IL",
            "license": "55812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21621949",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Multi-Specialty Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.