NPIMap

Organization Active NPI

Inner-City Muslim Action Network

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
National Provider Identifier
1760975304
Registry record updated Jun 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
INNER-CITY MUSLIM ACTION NETWORK
Practice address
2744 W 63Rd St BLDG 2
Chicago, IL 60629-2343
Phone
(773) 434-4626
Fax
(773) 303-8858
NPI assigned
Jun 8, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2018

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

Authorized official

Name
Rami Nashashibi
Title
Executive Director
Phone
(773) 434-4626

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X IL Primary

Addresses

Primary practice location

2744 W 63Rd St BLDG 2
Chicago, IL 60629-2343

Mailing address

2744 W 63Rd St
Chicago, IL 60629-2343
Phone (773) 434-4626

Other names 1

  • IMAN Oral Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Inner-City Muslim Action Network6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1528416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528416000000",
    "number": "1760975304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2744 W 63RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606292343",
            "telephone_number": "773-434-4626",
            "fax_number": "773-303-8858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2744 W 63RD ST BLDG 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606292343",
            "telephone_number": "773-434-4626",
            "fax_number": "773-303-8858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNER-CITY MUSLIM ACTION NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-08",
        "last_updated": "2018-06-08",
        "status": "A",
        "authorized_official_last_name": "NASHASHIBI",
        "authorized_official_first_name": "RAMI",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "773-434-4626"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IMAN Oral Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "IMAN Oral Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2018; 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.