South Side Medical Group LTD.

Primary specialty

SpecialistTaxonomy code 174400000X

License

036113409 Issued in IL

Legal business name

SOUTH SIDE MEDICAL GROUP LTD.

Practice address

1111 E 87TH St Ste 100B
Chicago, IL 60619-7062

Phone

(773) 376-0665

Fax

(773) 767-3944

NPI assigned

Jul 15, 2009

Organization subpart

No

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

Authorized official

Name

Rahil Khan, MD

Title

Owner

Phone

(773) 376-0665

Specialties & licenses 2

Addresses

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.

• Nikki Kris Minyard, PT

  • Physical Therapist
  • Louisville, KY
  • NPI 1407451594
  NPD (past)

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

{
    "created_epoch": "1247616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247616000000",
    "number": "1427288273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 E 87TH ST STE 100B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606197062",
            "telephone_number": "773-376-0665",
            "fax_number": "773-767-3944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 E 87TH ST STE 100B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606197062",
            "telephone_number": "773-376-0665",
            "fax_number": "773-767-3944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SIDE MEDICAL GROUP LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-15",
        "last_updated": "2009-07-15",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "RAHIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-376-0665",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038010670",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "036113409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Shore Med & Rehab Center
• South Shore Radiologists, S.C.
• South Shore School of Leadership Health Center (Friedell Primary Care)
• South Side Healthy Community Organization, Inc
• South Side Help Center
• South Side Pharmacy, Inc.
• South Suburban Health Professionals PC
• South-East Asia Center
• Ahnawee South, MSN, APRN, FNP-C
• Kara Southard

• Specialist in Chicago, IL
• Providers in Chicago, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2009; 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.