NPIMap

Organization Active NPI

Medreat

  • Clinic/Center
  • Deerfield, IL
National Provider Identifier
1487262192
Registry record updated Sep 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
MEDREAT
Practice address
1436 Deerfield Rd
Deerfield, IL 60015-2758
Phone
(312) 731-0331
NPI assigned
Jul 20, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2020

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

Authorized official

Name
Kojiro Matsumoto, MDNPI 1780813840
Title
President
Phone
(708) 300-8881

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1436 Deerfield Rd
Deerfield, IL 60015-2758

Mailing address

1436 Deerfield Rd
Deerfield, IL 60015-2758
Phone (708) 300-8881

National Provider Directory

National Provider Directory

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": "1595203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599004800000",
    "number": "1487262192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1436 DEERFIELD RD",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600152758",
            "telephone_number": "708-300-8881",
            "fax_number": "708-438-7709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1436 DEERFIELD RD",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600152758",
            "telephone_number": "312-731-0331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDREAT",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-20",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A",
        "authorized_official_last_name": "MATSUMOTO",
        "authorized_official_first_name": "KOJIRO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-300-8881",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2020; 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.