Organization Active NPI

Midwest Medical Systems Inc

  • Rheumatology Physician
  • Aurora, IL
National Provider Identifier
1518064484
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
036-087-821 Issued in IL
Legal business name
MIDWEST MEDICAL SYSTEMS INC
Practice address
1177 N Highland Ave
Suite 201
Aurora, IL 60506-2281
Phone
(630) 801-7505
Fax
(630) 801-7511
NPI assigned
Sep 20, 2006
Last updated
Apr 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

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

Authorized official

Name
Dr. Gowhar Khan, MDNPI 1518917673
Title
President
Phone
(630) 802-8644

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 070-002-882 IL
Family Medicine Physician 207Q00000X 036111540 IL
Internal Medicine Physician 207R00000X 036-087-821 IL
Rheumatology Physician 207RR0500X 036-087-821 IL Primary

Addresses

Primary practice location

1177 N Highland Ave
Suite 201
Aurora, IL 60506-2281

Mailing address

2309 Bilter Rd
Aurora, IL 60502-8714
Phone (630) 428-3600

Other identifiers 1

IdentifierTypeStateIssuer
036087821MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060104000392 IL Part B Supplier - Clinic/Group Practice 3375566490 Receives reassigned benefits from 2 practitioners
Practice locations: Aurora, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649635200000",
    "number": "1518064484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2309 BILTER RD",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605028714",
            "telephone_number": "630-428-3600",
            "fax_number": "630-428-1710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1177 N HIGHLAND AVE",
            "address_2": "SUITE 201",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605062281",
            "telephone_number": "630-801-7505",
            "fax_number": "630-801-7511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST MEDICAL SYSTEMS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "GOWHAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-802-8644",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "IL",
            "license": "070-002-882",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036111540",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-087-821",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "IL",
            "license": "036-087-821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036087821",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2022; 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.