NPIMap

Organization Active NPI

Frankfort Medical Clinic

  • Internal Medicine Physician
  • Olympia Fields, IL
National Provider Identifier
1669635223
Registry record updated Jul 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
63103449 Issued in IL
Legal business name
FRANKFORT MEDICAL CLINIC
Practice address
3800 W 203Rd St
Suite 201
Olympia Fields, IL 60461-1184
Phone
(815) 464-7212
NPI assigned
Jul 3, 2008
Organization subpart
Yes
Parent organization
FRANKFORT MEDICAL CLINICAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 31, 2008

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

Authorized official

Name
Mrs. Kiayona Torres
Title
Billing
Phone
(219) 756-3988

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 63103449 IL Primary

Addresses

Primary practice location

3800 W 203Rd St
Suite 201
Olympia Fields, IL 60461-1184

Mailing address

1480 Momentum PL
Chicago, IL 60689-5314

Other identifiers 1

IdentifierTypeStateIssuer
036103449MedicaidIL

National Provider Directory

National Provider Directory
Tax ID family
Khaja Asadullah MD SC2 organizations share this tax ID, including this one
Part of
Khaja Asadullah MD SC

Other organizations with this tax ID 1

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

Locations

1480 Momentum Pl
Chicago, IL 60689

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 5

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": "1215043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217462400000",
    "number": "1669635223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 MOMENTUM PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606895314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 W 203RD ST",
            "address_2": "SUITE 201",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611184",
            "telephone_number": "815-464-7212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANKFORT MEDICAL CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRANKFORT MEDICAL CLINIC",
        "enumeration_date": "2008-07-03",
        "last_updated": "2008-07-31",
        "status": "A",
        "authorized_official_last_name": "TORRES",
        "authorized_official_first_name": "KIAYONA",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "219-756-3988",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "63103449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036103449",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia Fields, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.