Chicago Family Medical Center Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

036065312 Issued in IL

Legal business name

CHICAGO FAMILY MEDICAL CENTER INC

Practice address

1512 W Chicago Ave
Suite 1
Chicago, IL 60642-5204

Phone

(630) 495-3333

NPI assigned

May 7, 2014

Organization subpart

No

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

Authorized official

Name

Mohammed Riazuddin, MD

Title

President

Phone

(630) 495-3333

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1399420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399420800000",
    "number": "1396155669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 W CHICAGO AVE",
            "address_2": "SUITE 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606425204",
            "telephone_number": "630-495-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 W CHICAGO AVE",
            "address_2": "SUITE 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606425204",
            "telephone_number": "630-495-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO FAMILY MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-07",
        "last_updated": "2014-05-07",
        "status": "A",
        "authorized_official_last_name": "RIAZUDDIN",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-495-3333",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IL",
            "license": "036065312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1588755409",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.