Northwest Medical and Urgent Care Center at Yale and 95TH LTD

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

NORTHWEST MEDICAL AND URGENT CARE CENTER AT YALE AND 95TH LTD

Practice address

237 W 95TH St
Chicago, IL 60628-1321

Phone

(773) 468-2110

Fax

(773) 468-2109

NPI assigned

Nov 13, 2017

Last updated

Oct 24, 2018By 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

Dr. Mohammad Khamis, MD

Title

President

Phone

(773) 468-2110

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Bernetta Cannon, FNP-C

  • Family Nurse Practitioner
  • Chicago, IL
  • NPI 1891480950
  NPD

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

{
    "created_epoch": "1510531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540339200000",
    "number": "1457864407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5352 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606252316",
            "telephone_number": "773-353-5047",
            "fax_number": "773-353-2406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 W 95TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606281321",
            "telephone_number": "773-468-2110",
            "fax_number": "773-468-2109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST MEDICAL AND URGENT CARE CENTER AT YALE AND 95TH LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-13",
        "last_updated": "2018-10-24",
        "status": "A",
        "authorized_official_last_name": "KHAMIS",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-468-2110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036112029",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northwest Health Care, LTD
• Northwest Home Care, Inc. (Abcor Home Health, Inc.)
• Northwest Labs LLC
• Northwest Medical and Urgent Care Center at Madison LTD
• Northwest Medical and Urgent Care Center at South Shore LLC
• Northwest Medical Associates of Chicago LLC
• Northwest Medical Foundation Inc
• Northwest Medical Imaging
• Northwest Orthopaedic Assoc LTD
• Northwest Orthopaedic Associates Dba Northwest Physical Therapy (dba Northwest Physical Therapy Associates)

• Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2018; 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.