Organization Active NPI

Southwest Urgent Care LTD

  • Family Medicine Physician
  • Evergreen Park, IL
National Provider Identifier
1750746681
Registry record updated Dec 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SOUTHWEST URGENT CARE LTD
Practice address
2955 W 95TH St
Evergreen Park, IL 60805-2409
Phone
(708) 200-6615
Fax
(708) 598-3304
NPI assigned
Dec 18, 2015
Last updated
Dec 18, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2015

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

Authorized official

Name
Hanan Yousif
Title
President
Phone
(708) 200-6615

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Internal Medicine Physician 207R00000X

Addresses

Primary practice location

2955 W 95TH St
Evergreen Park, IL 60805-2409

Mailing address

8790 W 103Rd St
Palos Hills, IL 60465-1603
Phone (708) 200-6615

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160212000688 IL Part B Supplier - Clinic/Group Practice 0648574574 Receives reassigned benefits from 3 practitioners
Practice locations: Tinley Park, IL; Oak Lawn, IL; Evergreen Park, IL; Oak Forest, IL; Chicago, 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
14D2110020Southwest Urgent Care LTD2955 West 95TH St, Evergreen Park, IL 60805Certificate of waiverMar 6, 2028

National Provider Directory

National Provider Directory

Locations

7460 Duvan Dr
Tinley Park, IL 60477
Phone (708) 649-0333

Practitioners & affiliated clinicians

Practitioners 3

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": "1450396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450396800000",
    "number": "1750746681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8790 W 103RD ST",
            "city": "PALOS HILLS",
            "state": "IL",
            "postal_code": "604651603",
            "telephone_number": "708-200-6615",
            "fax_number": "708-598-3304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2955 W 95TH ST",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052409",
            "telephone_number": "708-200-6615",
            "fax_number": "708-598-3304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST URGENT CARE LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-18",
        "last_updated": "2015-12-18",
        "status": "A",
        "authorized_official_last_name": "YOUSIF",
        "authorized_official_first_name": "HANAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-200-6615"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2015; 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.