Active NPI
Maimoona Aijaz MDSC
- Internal Medicine Physician
- Joliet, IL
National Provider Identifier
1467572503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- MAIMOONA AIJAZ MDSC
- Practice address
- 1717 Glenwood Ave
Joliet, IL 60435-5835 - Phone
- (815) 744-8600
- NPI assigned
- Mar 30, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sadna Mohan
- Title
- President
- Phone
- (630) 904-7200
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
1717 Glenwood Ave
Joliet, IL 60435-5835
Mailing address
1717 Glenwood Ave
Joliet, IL 60435-5835
Phone (815) 744-8600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040702000075 | IL | Part B Supplier - Clinic/Group Practice | 4385621895 |
Receives reassigned benefits from 1 practitioner Practice locations: Joliet, IL |
National Provider Directory
National Provider DirectoryLocations
1717 Glenwood Ave
Joliet, IL 60435
Phone (815) 744-8600
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175212800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1373241600000",
"number": "1467572503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1717 GLENWOOD AVE",
"city": "JOLIET",
"state": "IL",
"postal_code": "604355835",
"telephone_number": "815-744-8600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 GLENWOOD AVE",
"city": "JOLIET",
"state": "IL",
"postal_code": "604355835",
"telephone_number": "815-744-8600"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MAIMOONA AIJAZ MDSC",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-30",
"last_updated": "2013-07-08",
"status": "A",
"authorized_official_last_name": "MOHAN",
"authorized_official_first_name": "SADNA",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "630-904-7200"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Joliet, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2013; 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.