NPIMap

Organization Active NPI

HD Medspa & Clinic

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1194126573
Registry record updated Sep 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
1908417 Issued in IL
Legal business name
HD MEDSPA & CLINIC
Practice address
3615 N Ashland Ave
Ste 1N
Chicago, IL 60613-4789
Phone
(773) 770-6300
Fax
(773) 665-5007
NPI assigned
Sep 4, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2014

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

Authorized official

Name
Dr. Harold Diaz, M.D.NPI 1508886409
Title
Owner
Phone
(773) 770-6300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 1908417 IL Primary

Addresses

Primary practice location

3615 N Ashland Ave
Ste 1N
Chicago, IL 60613-4789

Mailing address

3615 N Ashland Ave
Ste 1N
Chicago, IL 60613-4789
Phone (773) 770-6300

National Provider Directory

National Provider Directory
Tax ID family
Colmed Clinic LTD2 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.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1409788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409788800000",
    "number": "1194126573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3615 N ASHLAND AVE",
            "address_2": "STE 1N",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606134789",
            "telephone_number": "773-770-6300",
            "fax_number": "773-665-5007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3615 N ASHLAND AVE",
            "address_2": "STE 1N",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606134789",
            "telephone_number": "773-770-6300",
            "fax_number": "773-665-5007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HD MEDSPA & CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-04",
        "last_updated": "2014-09-04",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "HAROLD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-770-6300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "1908417",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 4, 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.