Suburban Primary Care

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0042000916 Issued in IL

Legal business name

SUBURBAN PRIMARY CARE

Practice address

121 S Wilke Rd
Suite 110
Arlington Heights, IL 60005-1533

Phone

(847) 398-4536

Fax

(847) 398-4712

NPI assigned

Jan 26, 2008

Last updated

Jan 26, 2008By 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

Dr. Mamdouh Latif Ishak, M.D.NPI 1275612343

Title

President

Phone

(847) 398-4536

Specialties & licenses 1

Addresses

Locations

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.

• Mamdouh Latif Ishak, MD

  • Internal Medicine Physician
  • Arlington Heights, IL
  • NPI 1275612343
  Authorized official Same address or phone

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

{
    "created_epoch": "1201305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201305600000",
    "number": "1114104783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 S WILKE RD",
            "address_2": "SUITE 110",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600051533",
            "telephone_number": "847-398-4536",
            "fax_number": "847-398-4712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 S WILKE RD",
            "address_2": "SUITE 110",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600051533",
            "telephone_number": "847-398-4536",
            "fax_number": "847-398-4712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-26",
        "last_updated": "2008-01-26",
        "status": "A",
        "authorized_official_last_name": "ISHAK",
        "authorized_official_first_name": "MAMDOUH",
        "authorized_official_middle_name": "LATIF",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-398-4536",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "0042000916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ladouglas J Suber, MD
• Suburban Associates in Ophthalmology LLC
• Suburban Associates in Ophthalmology LLC
• Suburban Associates in Ophthalmology LLC
• Suburban Endocrinology & Diabetes (Suburban Endocrinology & Diabetes Center)
• Suburban Seniors, Inc.
• Grace K Suh, M.D.
• William Suhr, M.D.
• Sukhjinder Thind, DDS, PC (Definate Dental Solutions)
• Carol Sulatycke, M.S. ED.

• Internal Medicine Physician in Arlington Heights, IL
• Providers in Arlington Heights, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2008; 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.