Maimanat Nizam, M.D.

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

036-069635 Issued in IL

Practice address

2001 W 69TH St
Chicago, IL 60636-3262

Phone

(773) 778-2355

Fax

(773) 778-2355

NPI assigned

Jan 30, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mamanatandathernizampc.

  • Community Health Clinic/Center
  • Chicago, IL
  • NPI 1104134915
  NPD (past) Authorized official

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371081600000",
    "number": "1265579262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 TAMERTON PKWY",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605276347",
            "telephone_number": "630-654-1021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 W 69TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606363262",
            "telephone_number": "773-778-2355",
            "fax_number": "773-778-2355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIZAM",
        "first_name": "MAIMANAT",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2013-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "IL",
            "license": "036-069635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036069635",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Naomi J Nixon, O.D.
• Phoebe Nixon, DNP, AGPCNP-BC
• Rebecca E Nixon, MS, OTR/L
• Niyya Care
• Ather Nizam, M.D.
• Mohamad Hasan Nizam, MD
• Kiran Nizamani, MD
• Junaid Nizamuddin
• Mohammad Nizamuddin
• Sarah Nizamuddin

• Adult Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Adult Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2013; 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.