Illinois Medical Care LTD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036094781 Issued in IL

Legal business name

ILLINOIS MEDICAL CARE LTD

Practice address

5025 N Paulina St
Chicago, IL 60640-2772

Phone

(773) 931-8082

Fax

(888) 847-9526

NPI assigned

Mar 19, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Maher Al-Koubaytari, MDNPI 1437124419

Title

President

Phone

(773) 931-8082

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Maher Al-Koubaytari, M.D.

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1437124419
  Medicare reassignment Care Compare group NPD Authorized official
• Mutazz Haj Darweesh, M.D.

  • Hospitalist Physician
  • Chicago, IL
  • NPI 1205934395

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Jay Declarador

  • Nurse Practitioner
  • Chicago, IL
  • NPI 1417460502
  Medicare reassignment NPD
• Mohamed I Jabri, MD

  • Emergency Medicine Physician
  • Naperville, IL
  • NPI 1013026004
  Medicare reassignment NPD

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517270400000",
    "number": "1508980889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 GREENDALE AVE",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681926",
            "telephone_number": "773-931-8082",
            "fax_number": "888-847-9526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5025 N PAULINA ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402772",
            "telephone_number": "773-931-8082",
            "fax_number": "888-847-9526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS MEDICAL CARE LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2018-01-30",
        "status": "A",
        "authorized_official_last_name": "AL-KOUBAYTARI",
        "authorized_official_first_name": "MAHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-931-8082",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036094781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036094781",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Illinois Institute for Integrative Mental Health LTD
• Illinois Institute of Gynecology and Advanced Pelvic Surgery, SC
• Illinois Kidney Care PLLC
• Illinois Masonic Hospital
• Illinois Medical Care and Consulting, LLC
• Illinois Medical Group SC
• Illinois Medical Specialists PC
• Illinois Mobile Foot Care LLC
• Illinois Mobile Therapy Group LLC
• Illinois Orthopedic Network, LLC

• Internal Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2018; 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.

Verify at the official NPI Registry.