Thinfast MD Rockford

Primary specialty

Obesity Medicine (Family Medicine) PhysicianTaxonomy code 207QB0002X

License

209007392 Issued in IL

Legal business name

THINFAST MD ROCKFORD

Practice address

461 N Mulford Rd Ste 9
Rockford, IL 61107-5165

Phone

(815) 229-1899

NPI assigned

May 25, 2012

Last updated

Jun 6, 2014By 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

Mr. Jameel Ahamed

Title

Office Biller

Phone

(847) 227-0293

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Thinfast MD3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Thinfast MD LLC

  • Obesity Medicine (Family Medicine) Physician
  • Arlington Heights, IL
  • NPI 1518223692
  NPD tax ID
• Thinfast MD Naperville

  • Obesity Medicine (Family Medicine) Physician
  • Naperville, IL
  • NPI 1750647855
  NPD tax ID

Locations

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.

• Ehtesham J Ghani, MD

  • Internal Medicine Physician
  • Brookfield, IL
  • NPI 1316988397
  NPD (past)

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

{
    "created_epoch": "1337904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402012800000",
    "number": "1366702292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 N MULFORD RD",
            "address_2": "STE 9",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075190",
            "telephone_number": "815-229-1899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 N MULFORD RD STE 9",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075165",
            "telephone_number": "815-229-1899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THINFAST MD ROCKFORD",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-25",
        "last_updated": "2014-06-06",
        "status": "A",
        "authorized_official_last_name": "AHAMED",
        "authorized_official_first_name": "JAMEEL",
        "authorized_official_title_or_position": "OFFICE BILLER",
        "authorized_official_telephone_number": "847-227-0293",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207QB0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Obesity Medicine",
            "state": "IL",
            "license": "209007392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-126253",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tabitha Mae Theiler, RST, CST
• Timothy Allen Theisen, DDS, MS
• Theodore S. Ingrassia, III, M.D.S.C.
• Annelise Thifault
• Jennifer Thilges, APRN
• David T Thom, DPM
• Sylvia Thoman, O.D.
• Thomas a Runne DPM LTD
• Thomas B. Dudgeon, PH.D., PC
• Anita Ann Thomas Bua, LCPC,LPC

• Obesity Medicine (Family Medicine) Physician in Rockford, IL
• Providers in Rockford, IL by specialty
• Obesity Medicine (Family Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2014; 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.