NPIMap

Organization Active NPI

Roselle Physical Medicine Group

  • Chiropractor
  • Roselle, IL
National Provider Identifier
1255720975
Registry record updated Jan 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038008665 Issued in IL
Legal business name
ROSELLE PHYSICAL MEDICINE GROUP
Practice address
50 E Irving Park Rd
Roselle, IL 60172-2050
Phone
(630) 295-8851
Fax
(630) 295-8852
NPI assigned
Jan 19, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2015

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

Authorized official

Name
Dr. Tariq Ahmed, D.C
Title
President
Phone
(630) 295-8851

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 038008665 IL Primary

Addresses

Primary practice location

50 E Irving Park Rd
Roselle, IL 60172-2050

Mailing address

50 E Irving Park Rd
Roselle, IL 60172-2050
Phone (630) 295-8851

National Provider Directory

National Provider Directory
Tax ID family
Roselle Physical Medicine Group2 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.

NPI Registry JSON

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

{
    "created_epoch": "1421625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421625600000",
    "number": "1255720975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 E IRVING PARK RD",
            "city": "ROSELLE",
            "state": "IL",
            "postal_code": "601722050",
            "telephone_number": "630-295-8851",
            "fax_number": "630-295-8852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 E IRVING PARK RD",
            "city": "ROSELLE",
            "state": "IL",
            "postal_code": "601722050",
            "telephone_number": "630-295-8851",
            "fax_number": "630-295-8852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSELLE PHYSICAL MEDICINE GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-19",
        "last_updated": "2015-01-19",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "TARIQ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-295-8851",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038008665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roselle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.