Organization Active NPI

Miamedspa LTD

  • Plastic and Reconstructive Surgery Physician
  • Oakbrook Terrace, IL
National Provider Identifier
1730513425
Registry record updated Aug 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
036-093168 Issued in IL
Legal business name
MIAMEDSPA LTD
Practice address
1 Transam Plaza Dr
Suite 16
Oakbrook Terrace, IL 60181-4364
Phone
(630) 827-2500
NPI assigned
Aug 29, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2013

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

Authorized official

Name
Moqueet Syed
Title
Manager
Phone
(630) 827-2500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0122X 036-093168 IL Primary

Addresses

Primary practice location

1 Transam Plaza Dr
Suite 16
Oakbrook Terrace, IL 60181-4364

Mailing address

1 Transam Plaza Dr
Suite 16
Oakbrook Terrace, IL 60181-4364

Other identifiers 1

IdentifierTypeStateIssuer
036-093168OtherILSTATE LICENSE

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1377734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377734400000",
    "number": "1730513425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 TRANSAM PLAZA DR",
            "address_2": "SUITE 16",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601814364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TRANSAM PLAZA DR",
            "address_2": "SUITE 16",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601814364",
            "telephone_number": "630-827-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIAMEDSPA LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-29",
        "last_updated": "2013-08-29",
        "status": "A",
        "authorized_official_last_name": "SYED",
        "authorized_official_first_name": "MOQUEET",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "630-827-2500"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "IL",
            "license": "036-093168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "036-093168",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakbrook Terrace, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2013; 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.