NPIMap

Organization Active NPI

Inner-City Muslim Action Network

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
National Provider Identifier
1770020828
Registry record updated Sep 26, 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
Chicago, IL 60629-2343
Phone
(773) 434-4626
Fax
(773) 776-3623
NPI assigned
Jan 27, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2018

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

2744 W 63Rd St
Chicago, IL 60629-2343

Mailing address

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

Other practice location 1

2744 W 63rd St
Building 2
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.

Locations

2744 W 63rd St
Bldg 2
Chicago, IL 60629
Phone (773) 434-4626

NPI Registry JSON

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

{
    "created_epoch": "1485475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537920000000",
    "number": "1770020828",
    "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": "773-776-3623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2744 W 63RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606292343",
            "telephone_number": "773-434-4626",
            "fax_number": "773-776-3623"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2744 W 63rd St",
            "address_2": "Building 2",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606292343",
            "country_code": "US",
            "telephone_number": "773-434-4626",
            "fax_number": "773-303-8858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INNER-CITY MUSLIM ACTION NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-27",
        "last_updated": "2018-09-26",
        "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",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "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 Sep 26, 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.