NPIMap

Organization Active NPI

Illinois Medical Group SC

  • Multi-Specialty Clinic/Center
  • Chicago, IL
National Provider Identifier
1649219007
Registry record updated Jun 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
042618822 Issued in IL
Legal business name
ILLINOIS MEDICAL GROUP SC
Practice address
4211 N Cicero Ave
Chicago, IL 60641-1651
Phone
(773) 545-6900
Fax
(773) 685-2481
NPI assigned
Jun 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2008

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

Authorized official

Name
Dr. Sarmed G Elias, M.D.
Title
President
Phone
(773) 545-6900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X 042618822 IL Primary

Addresses

Primary practice location

4211 N Cicero Ave
Chicago, IL 60641-1651

Mailing address

4211 N Cicero Ave
Chicago, IL 60641-1651
Phone (773) 545-6900

Other identifiers 1

IdentifierTypeStateIssuer
DG1734OtherILMEDICARE RAILROAD

National Provider Directory

National Provider Directory

Locations

4211 N Cicero Ave
Ste 214
Chicago, IL 60641
Phone (773) 545-6900

Practitioners & affiliated clinicians

Practitioners 11

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

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213228800000",
    "number": "1649219007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4211 N CICERO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606411651",
            "telephone_number": "773-545-6900",
            "fax_number": "773-685-2481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 N CICERO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606411651",
            "telephone_number": "773-545-6900",
            "fax_number": "773-685-2481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS MEDICAL GROUP SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2008-06-12",
        "status": "A",
        "authorized_official_last_name": "ELIAS",
        "authorized_official_first_name": "SARMED",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-545-6900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "IL",
            "license": "042618822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DG1734",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2008; 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.