Midway Internal Medicine SC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MIDWAY INTERNAL MEDICINE SC

Practice address

4901 W 79TH St
Suite 5
Burbank, IL 60459-1554

Phone

(709) 952-4403

Fax

(708) 952-4404

NPI assigned

Nov 13, 2006

Organization subpart

No

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

Authorized official

Name

Hema Mathur, MD

Title

President

Phone

(708) 952-4403

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241395200000",
    "number": "1255402194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4901 W 79TH ST",
            "address_2": "SUITE 5",
            "city": "BURBANK",
            "state": "IL",
            "postal_code": "604591554",
            "telephone_number": "709-952-4403",
            "fax_number": "708-952-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 W 79TH ST",
            "address_2": "SUITE 5",
            "city": "BURBANK",
            "state": "IL",
            "postal_code": "604591554",
            "telephone_number": "709-952-4403",
            "fax_number": "708-952-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWAY INTERNAL MEDICINE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2009-05-04",
        "status": "A",
        "authorized_official_last_name": "MATHUR",
        "authorized_official_first_name": "HEMA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-952-4403",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maureen E McQuaid, MS
• Med First Imaging Inc
• Waqar Mian, M.D.
• Michael Kowalik DDS LTD
• Michael Samborski DDS LTD
• Midwest Express Care 2, Inc
• Sara Mohammad
• Sana Mohsin, DO
• Sara Montes, M.S., CCC-SLP
• Teresa Nicole Montes, PT

• Internal Medicine Physician in Burbank, IL
• Providers in Burbank, 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 May 4, 2009; 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.