NPIMap

Organization Active NPI

US Medgroup of Illinois PC

  • Health Service Clinic/Center
  • Chicago, IL
National Provider Identifier
1457792772
Registry record updated Jun 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
US MEDGROUP OF ILLINOIS PC
Practice address
1230 W Lake St
Chicago, IL 60607-1602
Phone
(312) 666-0028
Fax
(312) 666-5214
NPI assigned
Jul 15, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2016

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

Authorized official

Name
Raad Yaldo, DO
Title
President and Treasurer
Phone
(972) 364-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

1230 W Lake St
Chicago, IL 60607-1602

Mailing address

5080 Spectrum Dr
Suite 1200 West
Addison, TX 75001-4648
Phone (972) 364-8000

Other names 1

  • Advanced Medical Specialists Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Advanced Medical Specialists6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1373846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466380800000",
    "number": "1457792772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5080 SPECTRUM DR",
            "address_2": "SUITE 1200 WEST",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750014648",
            "telephone_number": "972-364-8000",
            "fax_number": "214-775-4502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 W LAKE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071602",
            "telephone_number": "312-666-0028",
            "fax_number": "312-666-5214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "US MEDGROUP OF ILLINOIS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-15",
        "last_updated": "2016-06-20",
        "status": "A",
        "authorized_official_last_name": "YALDO",
        "authorized_official_first_name": "RAAD",
        "authorized_official_title_or_position": "PRESIDENT AND TREASURER",
        "authorized_official_telephone_number": "972-364-8000",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Medical Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 20, 2016; 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.