Suburban Medical Group Corp

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

SUBURBAN MEDICAL GROUP CORP

Practice address

200 N Gary Ave
Carol Stream, IL 60188-1834

Phone

(630) 326-8766

Fax

(630) 326-8768

NPI assigned

Apr 4, 2023

Organization subpart

No

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

Authorized official

Name

Mohd Mohiuddin, MDNPI 1154685089

Title

President

Phone

(630) 360-2958

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Suburban Medical Group Corp

  • Urgent Care Clinic/Center
  • Bolingbrook, IL
  • NPI 1871180901

  O20210203002845

  Same enrollment

Tax ID family

Suburban Medical Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Suburban Medical Group Corp

  • Urgent Care Clinic/Center
  • Bolingbrook, IL
  • NPI 1871180901
  NPD tax ID

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mohd Noman Mohiuddin, M.D

  • Family Medicine Physician
  • Mount Pleasant, WI
  • NPI 1154685089
  NPD Authorized official
• Sheena Aleena Eettickal, D.O

  • Family Medicine Physician
  • Carol Stream, IL
  • NPI 1356790653
  NPD
• Fatima Qadri, MD

  • Hospitalist Physician
  • McHenry, IL
  • NPI 1801417217
  NPD
• Uzair Misbahuddin Syed, M.D.

  • Family Medicine Physician
  • Wheaton, IL
  • NPI 1033366018
  NPD
• Tracey Ho

  • Physician Assistant
  • Bolingbrook, IL
  • NPI 1043081938
  NPD (past)
• Veera Qureshi, PA-C

  • Physician Assistant
  • Bolingbrook, IL
  • NPI 1811678675
  NPD (past)
• Brooke Sheridan, NP

  • Family Nurse Practitioner
  • Bolingbrook, IL
  • NPI 1770294290
  NPD (past)

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

{
    "created_epoch": "1680566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715299200000",
    "number": "1134824410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N GARY AVE",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601881834",
            "telephone_number": "630-326-8766",
            "fax_number": "630-326-8768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N GARY AVE",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601881834",
            "telephone_number": "630-326-8766",
            "fax_number": "630-326-8768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN MEDICAL GROUP CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-04",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A",
        "authorized_official_last_name": "MOHIUDDIN",
        "authorized_official_first_name": "MOHD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-360-2958",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Starlight Autism Therapy PLLC
• Taylor Stazzone, MOT, OTR/L
• Erin Rose Stella, PT, DPT, CSCS
• Danielle Kathleen Stimmell
• Sara Ruth Stoy, RN
• Charles Sugay, PTA
• John E Sullivan, D.D.S.
• Hiral Suthar
• Linda M Svazas, RPH
• Abdulaziz Syed, LCSW

• Urgent Care Clinic/Center in Carol Stream, IL
• Providers in Carol Stream, IL by specialty
• Urgent Care Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.