Northwest Chicago Medical LTD

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

203.000961 Issued in IL

Legal business name

NORTHWEST CHICAGO MEDICAL LTD

Practice address

2651 N Laramie Ave
Chicago, IL 60639-1613

Phone

(773) 745-0391

Fax

(773) 745-3506

NPI assigned

Nov 15, 2007

Last updated

Nov 12, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jack Chodzen, PTNPI 1376553628

Title

President

Phone

(773) 745-0391

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jack Chodzen, PT

  • Physical Therapist
  • Chicago, IL
  • NPI 1376553628
  Authorized official Same address or phone

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415750400000",
    "number": "1063693323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2651 N LARAMIE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606391613",
            "telephone_number": "773-745-0391",
            "fax_number": "773-745-3506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2651 N LARAMIE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606391613",
            "telephone_number": "773-745-0391",
            "fax_number": "773-745-3506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST CHICAGO MEDICAL LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-15",
        "last_updated": "2014-11-12",
        "status": "A",
        "authorized_official_last_name": "CHODZEN",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-745-0391",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "203.000961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northtown Drugs (Goldenson Drugs, Inc.)
• Northwest Adult Wellness Center LLC
• Northwest Advanced Surgical Associates, SC
• Northwest Ambucare
• Northwest Anesthesiologists, S.C.
• Northwest Chicago Primary Care SC
• Northwest Chiropractix Inc.
• Northwest Dentistry
• Northwest ENT Associates, S.C.
• Northwest General Surgeons LTD

• Durable Medical Equipment & Medical Supplies in Chicago, IL
• Providers in Chicago, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2014; 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.