Active NPI
Universal Medical & Rehabilitation Center, S.C.
- Internal Medicine Physician
- Chicago, IL
National Provider Identifier
1124202031
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- UNIVERSAL MEDICAL & REHABILITATION CENTER, S.C.
- Practice address
- 2828 W Devon Ave
Chicago, IL 60659-1502 - Phone
- (773) 761-9774
- Fax
- (773) 761-9878
- NPI assigned
- Dec 27, 2007
- Last updated
- Dec 27, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Fatima M Mohiuddin, M.D.
- Title
- President
- Phone
- (847) 390-7122
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary | ||
| Physical Medicine & Rehabilitation Physician | 208100000X |
Addresses
Primary practice location
2828 W Devon Ave
Chicago, IL 60659-1502
Mailing address
9120 W Golf Rd
Niles, IL 60714-5806
Phone (847) 390-7122
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036079439 | Medicaid | IL | |
| 250733 | Other | IL | HARMONY |
| 21621391 | Other | IL | BLUE CROSS/BLUE SHIELD |
| 328026621001 | Medicaid | IL | |
| 335989271001 | Medicaid | IL | |
| 030004494 | Other | IL | RAILROAD MEDICARE |
| 036092848 | Medicaid | IL | |
| 4140282 | Other | IL | AETNA |
| 0404246 | Other | IL | UNITEDHEALTHCARE |
| 110239089 | Other | IL | RAILROAD MEDICARE |
| 1156492 | Other | IL | FIRST HEALTH |
National Provider Directory
National Provider DirectoryLocations
2828 W Devon Ave
Chicago, IL 60659
Phone (773) 761-9774
Practitioners & affiliated clinicians
Practitioners 2
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.
-
- Internal Medicine Physician
- Niles, IL
- NPI 1245321900
-
- Physical Medicine & Rehabilitation Physician
- Crete, IL
- NPI 1730270406
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198713600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1198713600000",
"number": "1124202031",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9120 W GOLF RD",
"city": "NILES",
"state": "IL",
"postal_code": "607145806",
"telephone_number": "847-390-7122",
"fax_number": "847-390-7115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2828 W DEVON AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606591502",
"telephone_number": "773-761-9774",
"fax_number": "773-761-9878"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "UNIVERSAL MEDICAL & REHABILITATION CENTER, S.C.",
"organizational_subpart": "NO",
"enumeration_date": "2007-12-27",
"last_updated": "2007-12-27",
"status": "A",
"authorized_official_last_name": "MOHIUDDIN",
"authorized_official_first_name": "FATIMA",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "18473907122",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036079439",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARMONY",
"identifier": "250733",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "21621391",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "328026621001",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "335989271001",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "030004494",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036092848",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4140282",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITEDHEALTHCARE",
"identifier": "0404246",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "110239089",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "1156492",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}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 Dec 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.