Organization Active NPI

Midwest Internal Medicine SC

  • Internal Medicine Physician
  • Decatur, IL
National Provider Identifier
1194777268
Registry record updated Sep 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MIDWEST INTERNAL MEDICINE SC
Practice address
2975 N Water St
Decatur, IL 62526-4235
Phone
(217) 875-3810
Fax
(217) 875-5015
NPI assigned
May 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2015

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

Authorized official

Name
Muhammad N Khan, MDNPI 1598767493
Title
Physician Owner
Phone
(217) 875-3810

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2975 N Water St
Decatur, IL 62526-4235

Mailing address

2975 N Water St
Decatur, IL 62526-4235
Phone (217) 875-3810

Other identifiers 1

IdentifierTypeStateIssuer
DN0325OtherILRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

441 W Hay St
Ste 3
Decatur, IL 62526
Phone (217) 875-3810

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442448000000",
    "number": "1194777268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2975 N WATER ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264235",
            "telephone_number": "217-875-3810",
            "fax_number": "217-875-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2975 N WATER ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264235",
            "telephone_number": "217-875-3810",
            "fax_number": "217-875-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST INTERNAL MEDICINE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2015-09-17",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "MUHAMMAD",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "217-875-3810",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DN0325",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.