NPIMap

Organization Active NPI

Internal Medicine and Family Physicians, SC

  • Internal Medicine Physician
  • Joliet, IL
National Provider Identifier
1730281536
Registry record updated Jun 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-105476 Issued in IL
Legal business name
INTERNAL MEDICINE AND FAMILY PHYSICIANS, SC
Practice address
1051 Essington Rd
Suite 290
Joliet, IL 60435-2801
Phone
(815) 773-0099
Fax
(815) 773-0088
NPI assigned
Sep 2, 2006
Last updated
Jun 14, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2010

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

Authorized official

Name
Dr. Samiullah M Choudry, M.D.NPI 1275715484
Title
President
Phone
(815) 773-0099

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
Internal Medicine Physician 207R00000X 036-105476 IL Primary

Addresses

Primary practice location

1051 Essington Rd
Suite 290
Joliet, IL 60435-2801

Mailing address

1051 Essington Road
Suite 290
Joliet, IL 60435-2842
Phone (815) 773-0099

Other identifiers 2

IdentifierTypeStateIssuer
0009932044OtherILBCBS
036105476MedicaidIL

National Provider Directory

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": "1157155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276473600000",
    "number": "1730281536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 ESSINGTON ROAD",
            "address_2": "SUITE 290",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604352842",
            "telephone_number": "815-773-0099",
            "fax_number": "815-773-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 ESSINGTON RD",
            "address_2": "SUITE 290",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604352801",
            "telephone_number": "815-773-0099",
            "fax_number": "815-773-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE AND FAMILY PHYSICIANS, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-02",
        "last_updated": "2010-06-14",
        "status": "A",
        "authorized_official_last_name": "CHOUDRY",
        "authorized_official_first_name": "SAMIULLAH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-773-0099",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-105476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0009932044",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036105476",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2010; 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.