Mayfair Familycare SC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

042007954 Issued in IL

Legal business name

MAYFAIR FAMILYCARE SC

Practice address

5115 N Francisco Ave
FL 1
Chicago, IL 60625-3611

Phone

(773) 271-6622

Fax

(773) 271-6801

NPI assigned

May 19, 2006

Organization subpart

No

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

Authorized official

Name

Bharat Kantilal Shah, M.D.

Title

President

Phone

(773) 271-6622

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420848000000",
    "number": "1396799037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5115 N FRANCISCO AVE",
            "address_2": "FL 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253611",
            "telephone_number": "773-271-6622",
            "fax_number": "773-271-6801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5115 N FRANCISCO AVE",
            "address_2": "FL 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253611",
            "telephone_number": "773-271-6622",
            "fax_number": "773-271-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYFAIR FAMILYCARE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2015-01-10",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "BHARAT",
        "authorized_official_middle_name": "KANTILAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-271-6622",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "042007954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110169119",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "21605075",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Kevin Mayes, D.D.S.
• Mary Jo Mayes, LPC
• Tracy James Mayes, MA LCPC
• Zerek Mayes, MSW, LCSW, EDD
• Mayfair Advantage MRI, Inc
• Mayfield Care and Rehabilitation Center LLC
• Mayfield Care Center LLC
• Mayfield Care Center, Inc.
• Cameron Lee Mayfield
• Cory Kishi Hiro Mayfield, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2015; 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.