Ann Medical Center SC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036-051648 Issued in IL

Legal business name

ANN MEDICAL CENTER SC

Practice address

4647 Lincoln Hwy
Matteson, IL 60443-2319

Phone

(708) 747-7720

Fax

(708) 915-7239

NPI assigned

Jun 9, 2006

Last updated

Nov 25, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Anjum Hameeduddin, M.D.NPI 1285633461

Title

Owner

Phone

(708) 747-7720

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anjum Hameeduddin, M.D.

  • Family Medicine Physician
  • Matteson, IL
  • NPI 1285633461
  Authorized official Same address or phone

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259107200000",
    "number": "1366483729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 250",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604430250",
            "telephone_number": "708-747-5850",
            "fax_number": "708-747-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4647 LINCOLN HWY",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604432319",
            "telephone_number": "708-747-7720",
            "fax_number": "708-915-7239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANN MEDICAL CENTER SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2009-11-25",
        "status": "A",
        "authorized_official_last_name": "HAMEEDUDDIN",
        "authorized_official_first_name": "ANJUM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-747-7720",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-051648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSIL GROUP #",
            "identifier": "1632848",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036051648",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Anderson, LCPC
• Katrina Agnes Anderson
• Salonia M Anderson, COTA/L
• Anderson's Durable Medical Equipment
• Angelcrest Hospice Corp
• Anointed Kindness Ehealth & Wellness PLLC
• Edith Christine Armstrong, SLP
• Jataeva Janay Arnold
• Ohimai Asein
• Temitope Adedamola Asein, PT

• Family Medicine Physician in Matteson, IL
• Providers in Matteson, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.