Tri Care Medical Group LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

TRI CARE MEDICAL GROUP LLC

Practice address

4332 N Elston Ave
Chicago, IL 60641-2144

Phone

(847) 891-6850

Fax

(630) 339-5803

NPI assigned

Apr 19, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Mohammad Azharuddin

Title

President

Phone

(847) 891-6850

Specialties & licenses 2

Addresses

Other names 1

• Northwest Immediate Care Doing business as

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

{
    "created_epoch": "1271635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271721600000",
    "number": "1598081333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1375 E SCHAUMBURG RD",
            "address_2": "STE 100",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601945166",
            "telephone_number": "847-891-6850",
            "fax_number": "630-339-5803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4332 N ELSTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606412144",
            "telephone_number": "847-891-6850",
            "fax_number": "630-339-5803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI CARE MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-19",
        "last_updated": "2010-04-20",
        "status": "A",
        "authorized_official_last_name": "AZHARUDDIN",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-891-6850",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwest Immediate Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alexandra M Trevino
• Alfonso Trevino Jr., MSW
• Celeste Marie Trevino, MS LCPC
• Michael Trevino, MD
• Richard R Trezona Jr., PH.D.
• Tri Star Pharmacy Inc
• Tri-Care, Inc.
• Christina Marie Tri, MA, LPC
• Samuel David Tri, DO
• Tria Aesthetics & Wellness

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2010; 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.