NPIMap

Organization Active NPI

Tamid Medical Group

  • Internal Medicine Physician
  • Riverwoods, IL
National Provider Identifier
1689744245
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
042005666 Issued in IL
Legal business name
TAMID MEDICAL GROUP
Practice address
1105 Milwaukee Ave
Riverwoods, IL 60015-3512
Phone
(847) 325-5110
Fax
(847) 325-5114
NPI assigned
Nov 9, 2006
Last updated
Jul 7, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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

Authorized official

Name
Dr. Tom Klein, M.D.NPI 1326094194
Title
President
Phone
(847) 325-5110

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 042005666 IL Primary

Addresses

Primary practice location

1105 Milwaukee Ave
Riverwoods, IL 60015-3512

Mailing address

1105 Milwaukee Ave
Riverwoods, IL 60015-3512
Phone (847) 325-5110

Other practice location 1

3825 N Central Ave
Chicago, IL 60634-2719
Phone (847) 325-5110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031210000657 IL Part B Supplier - Clinic/Group Practice 4587560594 Receives reassigned benefits from 10 practitioners
Practice locations: Chicago, IL; Riverwoods, IL

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D0426487Tamid Medical Group3825 N Central Ave, Chicago, IL 60634Certificate of waiverDec 22, 2027

National Provider Directory

National Provider Directory
Tax ID family
Tamid Medical Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 12

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": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657152000000",
    "number": "1689744245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 MILWAUKEE AVE",
            "city": "RIVERWOODS",
            "state": "IL",
            "postal_code": "600153512",
            "telephone_number": "847-325-5110",
            "fax_number": "847-325-5114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 MILWAUKEE AVE",
            "city": "RIVERWOODS",
            "state": "IL",
            "postal_code": "600153512",
            "telephone_number": "847-325-5110",
            "fax_number": "847-325-5114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3825 N Central Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606342719",
            "country_code": "US",
            "telephone_number": "847-325-5110",
            "fax_number": "847-325-5114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TAMID MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A",
        "authorized_official_last_name": "KLEIN",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-325-5110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "042005666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverwoods, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; 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.