Active NPI
Midway Medical Center
- Community/Behavioral Health Agency
- Chicago, IL
National Provider Identifier
1316545189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- MIDWAY MEDICAL CENTER
- Practice address
- 2 W 103Rd St
Chicago, IL 60628-2619 - Phone
- (313) 489-4715
- NPI assigned
- Oct 14, 2020
- Organization subpart
- Yes
- Parent organization
- MIDWAY MEDICAL CENTER
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Eunice Walker
- Title
- Director
- Phone
- (312) 489-4715
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | |||
| Community/Behavioral Health Agency | 251S00000X | Primary | ||
| Community Health Clinic/Center | 261QC1500X | |||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | |||
| Primary Care Clinic/Center | 261QP2300X | |||
| Clinical Medical Laboratory | 291U00000X |
Addresses
Primary practice location
2 W 103Rd St
Chicago, IL 60628-2619
Mailing address
PO Box 212
Crete, IL 60417-0212
Phone (313) 489-4715
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6676700 | Medicaid | IL |
Other names 1
- Midway Turning Point Center
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | eunice@midwaymedicalcenters.com | Direct | |
| SOAP URL | Chicago | Direct |
National Provider Directory
National Provider Directory- Tax ID family
- Midway Turning Point Community Center
- Part of
- Midway Turning Point Community Center
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Clinic/Center
- Chicago, IL
- NPI 1982324075
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Chicago, IL
- NPI 1588289359
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Chicago, IL
- NPI 1679212187
Locations
2 W 103rd St
Chicago, IL 60628
Phone (312) 489-4715
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Clinic/Center
- Chicago, IL
- NPI 1982324075
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602633600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1666310400000",
"number": "1316545189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 212",
"city": "CRETE",
"state": "IL",
"postal_code": "604170212",
"telephone_number": "313-489-4715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 W 103RD ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606282619",
"telephone_number": "313-489-4715"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MIDWAY MEDICAL CENTER",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "MIDWAY MEDICAL CENTER",
"enumeration_date": "2020-10-14",
"last_updated": "2022-10-21",
"certification_date": "2022-10-21",
"status": "A",
"authorized_official_last_name": "WALKER",
"authorized_official_first_name": "EUNICE",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "312-489-4715"
},
"taxonomies": [
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": null,
"license": null,
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QC1500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Community Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6676700",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "eunice@midwaymedicalcenters.com",
"affiliation": "N",
"endpointDescription": "office",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "2 W 103rd St",
"city": "Chicago",
"state": "IL",
"country_code": "US",
"postal_code": "606282619",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "Chicago",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "2 W 103rd St",
"city": "Chicago",
"state": "IL",
"country_code": "US",
"postal_code": "606282619",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Midway Turning Point Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.