Midwest Pediatrics Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

036093184 Issued in IL

Legal business name

MIDWEST PEDIATRICS INC

Doing business as

Midwest Pediatrics Inc

Practice address

7456 S State Rd
302
Bedford Park, IL 60638-6623

Phone

(708) 598-4100

Fax

(708) 598-0123

NPI assigned

May 11, 2016

Last updated

May 11, 2016By 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. Fouad Al-Qawasmi, M.D.

Title

Pediatrics

Phone

(708) 598-4100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Midwest Pediatrics Inc Doing business as

Locations

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

{
    "created_epoch": "1462924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462924800000",
    "number": "1538515234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7456 S STATE RD",
            "address_2": "302",
            "city": "BEDFORD PARK",
            "state": "IL",
            "postal_code": "606386623",
            "telephone_number": "708-598-4100",
            "fax_number": "708-598-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7456 S STATE RD",
            "address_2": "302",
            "city": "BEDFORD PARK",
            "state": "IL",
            "postal_code": "606386623",
            "telephone_number": "708-598-4100",
            "fax_number": "708-598-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST PEDIATRICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-11",
        "last_updated": "2016-05-11",
        "status": "A",
        "authorized_official_last_name": "AL-QAWASMI",
        "authorized_official_first_name": "FOUAD",
        "authorized_official_title_or_position": "PEDIATRICS",
        "authorized_official_telephone_number": "708-598-4100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": "036093184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036093184",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midwest Pediatrics Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Primary Care Clinic/Center in Bedford Park, IL
• Providers in Bedford Park, IL by specialty
• Primary Care Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2016; 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.