NPIMap

Organization Active NPI

Concentra Primary Care of Illinois PC

Doing business as MidAmerica Medical Associates

  • Primary Care Clinic/Center
  • Lincolnwood, IL
National Provider Identifier
1659642627
Registry record updated Jun 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
CONCENTRA PRIMARY CARE OF ILLINOIS PC
Doing business as
MidAmerica Medical Associates
Practice address
7126 N Lincoln Ave
Lincolnwood, IL 60712-2234
Phone
(847) 583-9189
NPI assigned
Jan 23, 2012
Last updated
Jun 17, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2015

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

Authorized official

Name
Dr. Raad Yaldo, DONPI 1598886996
Title
President
Phone
(972) 364-8000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary

Addresses

Primary practice location

7126 N Lincoln Ave
Lincolnwood, IL 60712-2234

Mailing address

5080 Spectrum Dr
Suite 1200 West
Addison, TX 75001-4648

Other names 1

  • MidAmerica Medical Associates Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Concentra Primary Care of Illinois PC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1327276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434499200000",
    "number": "1659642627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5080 SPECTRUM DR",
            "address_2": "SUITE 1200 WEST",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750014648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7126 N LINCOLN AVE",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607122234",
            "telephone_number": "847-583-9189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCENTRA PRIMARY CARE OF ILLINOIS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-23",
        "last_updated": "2015-06-17",
        "status": "A",
        "authorized_official_last_name": "YALDO",
        "authorized_official_first_name": "RAAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-364-8000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MidAmerica Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lincolnwood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.