Wajahat Mirza MD SC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

WAJAHAT MIRZA MD SC

Practice address

1170 E Belvidere Rd
Suite 212
Grayslake, IL 60030-2061

Phone

(847) 543-6814

Fax

(847) 543-0787

NPI assigned

Jan 11, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Wajahat Mirza, MDNPI 1245231570

Title

President

Phone

(847) 543-6814

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14731/brand/1/csg/1/fhir/r4

Practitioners 1

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

• Wajahat Mirza, MD

  • Cardiovascular Disease Physician
  • Grayslake, IL
  • NPI 1245231570
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200009600000",
    "number": "1669658308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170 E BELVIDERE RD",
            "address_2": "SUITE 212",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600302061",
            "telephone_number": "847-543-6814",
            "fax_number": "847-543-0787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 E BELVIDERE RD",
            "address_2": "SUITE 212",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600302061",
            "telephone_number": "847-543-6814",
            "fax_number": "847-543-0787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAJAHAT MIRZA MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-11",
        "last_updated": "2008-01-11",
        "status": "A",
        "authorized_official_last_name": "MIRZA",
        "authorized_official_first_name": "WAJAHAT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-543-6814",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Cardiovascular Disease Physician in Grayslake, IL
• Providers in Grayslake, IL by specialty
• Cardiovascular Disease Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.