Arlington Primary Care SC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036041272 Issued in IL

Legal business name

ARLINGTON PRIMARY CARE SC

Practice address

121 S Wilke Rd
Suite 110
Arlington Heights, IL 60005-1533

Phone

(847) 398-4536

Fax

(847) 398-4712

NPI assigned

Aug 28, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Mamdouh Latif Ishak, M.D.NPI 1275612343

Title

President

Phone

(847) 398-4536

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ARLINGTON PRIMARY CARE Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

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

• Mamdouh Latif Ishak, MD

  • Internal Medicine Physician
  • Arlington Heights, IL
  • NPI 1275612343
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1219881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429056000000",
    "number": "1205084571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 S WILKE RD",
            "address_2": "SUITE 110",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600051533",
            "telephone_number": "847-398-4536",
            "fax_number": "847-398-4712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 S WILKE RD",
            "address_2": "SUITE 110",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600051533",
            "telephone_number": "847-398-4536",
            "fax_number": "847-398-4712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARLINGTON PRIMARY CARE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-28",
        "last_updated": "2015-04-15",
        "status": "A",
        "authorized_official_last_name": "ISHAK",
        "authorized_official_first_name": "MAMDOUH",
        "authorized_official_middle_name": "LATIF",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-398-4536",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036041272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036041272",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ARLINGTON PRIMARY CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Arlington Multi Specialty Medical Center
• Arlington Nursing and Rehab Center LLC
• Arlington Orthodontics PC
• Arlington Pediatric Therapy Services, LTD
• Arlington Pediatrics, LTD.
• Arlington Psychological Services, LTD.
• Arlington Ridge Pathology SC
• Arlington Smith Family Dentistry LTD
• Maria Elisabeth Arman, MA, LPC
• Laura Palermo Arndt, OD

• Internal Medicine Physician in Arlington Heights, IL
• Providers in Arlington Heights, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2015; 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.