Individual provider Active NPI

Faramarz Salimi, MD

  • Ambulatory Surgical Clinic/Center
  • Morton Grove, IL
National Provider Identifier
1184865669
Registry record updated Jun 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
036-05577 Issued in IL
Practice address
6420 Lyons St
Morton Grove, IL 60053-1421
Phone
(847) 663-0816
Fax
(847) 398-4585
NPI assigned
Mar 13, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 036-05577 IL Primary

Addresses

Primary practice location

6420 Lyons St
Morton Grove, IL 60053-1421

Mailing address

6420 Lyons St
Morton Grove, IL 60053-1421
Phone (847) 663-0816

Other identifiers 3

IdentifierTypeStateIssuer
0021608339OtherBC/BS
036045577MedicaidIL
1518909399OtherILNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-05577ILMDAmbulatory Surgical Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
King Community Mental Health Center Corp CurrentSince Apr 27, 2009 Accepting new patients
Roueen Rafeyan MD LTD PastSince Apr 27, 2009 Accepting new patients

Locations

6033 N Sheridan Rd
Ste N6
Chicago, IL 60660
Phone (773) 275-4800

4455 S King Dr
Ste 101
Chicago, IL 60653
Phone (773) 536-2700

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1236902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433808000000",
    "number": "1184865669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6420 LYONS ST",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600531421",
            "telephone_number": "847-663-0816",
            "fax_number": "847-398-4585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 LYONS ST",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600531421",
            "telephone_number": "847-663-0816",
            "fax_number": "847-398-4585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALIMI",
        "first_name": "FARAMARZ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-13",
        "last_updated": "2015-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IL",
            "license": "036-05577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "0021608339",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036045577",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1518909399",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morton Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2015; 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.