NPIMap

Organization Active NPI

Wheeling Medical Clinic Inc

  • Family Medicine Physician
  • Wheeling, IL
National Provider Identifier
1790052132
Registry record updated Nov 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036048411 Issued in IL
Legal business name
WHEELING MEDICAL CLINIC INC
Practice address
505 N Wolf Rd
Wheeling, IL 60090-3027
Phone
(847) 279-3472
Fax
(847) 279-3473
NPI assigned
Nov 30, 2011
Last updated
Nov 30, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2011

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

Authorized official

Name
Ghodrat Sarrafi, MD
Title
Owner
Phone
(847) 279-3472

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036048411 IL Primary

Addresses

Primary practice location

505 N Wolf Rd
Wheeling, IL 60090-3027

Mailing address

505 N Wolf Rd
Wheeling, IL 60090-3027
Phone (847) 279-3472

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1322611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322611200000",
    "number": "1790052132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 N WOLF RD",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600903027",
            "telephone_number": "847-279-3472",
            "fax_number": "847-279-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 N WOLF RD",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600903027",
            "telephone_number": "847-279-3472",
            "fax_number": "847-279-3473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHEELING MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-30",
        "last_updated": "2011-11-30",
        "status": "A",
        "authorized_official_last_name": "SARRAFI",
        "authorized_official_first_name": "GHODRAT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-279-3472",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036048411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheeling, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; 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.