Infinitus Corporation

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036108385 Issued in IL

Legal business name

INFINITUS CORPORATION

Practice address

333 N Randall Rd
Suite 140
St Charles, IL 60174-1500

Phone

(800) 356-3627

NPI assigned

Jun 4, 2015

Organization subpart

No

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

Authorized official

Name

Moqueet Syed

Title

Credentialing Manager

Phone

(630) 440-7786

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433376000000",
    "number": "1588044507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N RANDALL RD",
            "address_2": "SUITE 140",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601741500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N RANDALL RD",
            "address_2": "SUITE 140",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601741500",
            "telephone_number": "800-356-3627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFINITUS CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-04",
        "last_updated": "2015-06-04",
        "status": "A",
        "authorized_official_last_name": "SYED",
        "authorized_official_first_name": "MOQUEET",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "630-440-7786"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036108385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROLLED SUBSTANCE LICENSE",
            "identifier": "336069152",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "036108385",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in St Charles, IL
• Providers in St Charles, 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 Jun 4, 2015; 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.