NPIMap

Organization Active NPI

Muzaffar Mirza

  • Dental Clinic/Center
  • Chicago, IL
National Provider Identifier
1407022536
Registry record updated Apr 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
019019459 Issued in IL
Legal business name
MUZAFFAR MIRZA
Practice address
4501 S State St
Chicago, IL 60609-3758
Phone
(773) 548-0600
Fax
(773) 548-0740
NPI assigned
May 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2014

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

Authorized official

Name
Miss Mona Mann
Title
Insurance Coordinator
Phone
(773) 548-0600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 019019459 IL Primary

Addresses

Primary practice location

4501 S State St
Chicago, IL 60609-3758

Mailing address

4501 S State St
Chicago, IL 60609-3758
Phone (773) 548-0600

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396828800000",
    "number": "1407022536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 S STATE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606093758",
            "telephone_number": "773-548-0600",
            "fax_number": "773-548-0740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 S STATE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606093758",
            "telephone_number": "773-548-0600",
            "fax_number": "773-548-0740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUZAFFAR MIRZA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-08",
        "last_updated": "2014-04-07",
        "status": "A",
        "authorized_official_last_name": "MANN",
        "authorized_official_first_name": "MONA",
        "authorized_official_title_or_position": "INSURANCE COORDINATOR",
        "authorized_official_telephone_number": "773-548-0600",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "019019459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 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.