Midwest Lakes Medical Center, SC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

36097343 Issued in IL

Legal business name

MIDWEST LAKES MEDICAL CENTER, SC

Practice address

690 E Terra Cotta Ave
Suite D
Crystal Lake, IL 60014-3605

Phone

(815) 455-8600

Fax

(815) 455-8601

NPI assigned

Apr 18, 2008

Last updated

Aug 19, 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

Mukesh Arora, MDNPI 1518975796

Title

Doctor

Phone

(815) 455-8600

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 5

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.

• Mukesh Arora, MD

  • Internal Medicine Physician
  • Crystal Lake, IL
  • NPI 1518975796
  Medicare reassignment NPD Authorized official
• Mohit Arora, M.D.

  • Hospitalist Physician
  • Crystal Lake, IL
  • NPI 1194986695

  Internal Medicine

  Medicare reassignment NPD
• Monica E Gavran, MD

  • Internal Medicine Physician
  • West Dundee, IL
  • NPI 1326123530
  NPD (past)
• Leo A Reyes, M.D.

  • Family Medicine Physician
  • Woodstock, IL
  • NPI 1811992316
  NPD (past)
• Susan J Rychlik, MD

  • Internal Medicine Physician
  • Sedona, AZ
  • NPI 1730164088
  NPD (past)

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

{
    "created_epoch": "1208476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408406400000",
    "number": "1417121500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 E TERRA COTTA AVE",
            "address_2": "SUITE D",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143605",
            "telephone_number": "815-455-8600",
            "fax_number": "815-455-8601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 E TERRA COTTA AVE",
            "address_2": "SUITE D",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143605",
            "telephone_number": "815-455-8600",
            "fax_number": "815-455-8601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST LAKES MEDICAL CENTER, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-18",
        "last_updated": "2014-08-19",
        "status": "A",
        "authorized_official_last_name": "ARORA",
        "authorized_official_first_name": "MUKESH",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "815-455-8600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "36097343",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036 097 343",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID",
            "identifier": "05623054",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John C Michael, MD
• Angela L Miciura, MD
• Midwest Center for Childrens Development NFP
• Midwest Endocrinology LLC
• Midwest Home Medical Supplies, LTD.
• Midwest Physical Therapy Ctr
• Midwest Wellness Healthcare
• Elizabeth A. Mihevc, OD
• Paolo Anthony Milana
• Milestones Therapy Center

• Internal Medicine Physician in Crystal Lake, IL
• Providers in Crystal Lake, 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 Aug 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.