Active NPI
Lockport Express Medical Group, Inc.
- Urgent Care Clinic/Center
- Lockport, IL
National Provider Identifier
1790053643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urgent Care Clinic/Center
- Legal business name
- LOCKPORT EXPRESS MEDICAL GROUP, INC.
- Practice address
- 16221 W. 159TH Street
Lockport, IL 60441-7959 - Phone
- (815) 588-1111
- Fax
- (815) 838-4305
- NPI assigned
- Dec 7, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Nagui Y Hanna, M.D.
- Title
- Physician/Owner
- Phone
- (630) 960-1658
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urgent Care Clinic/Center | 261QU0200X | Primary |
Addresses
Primary practice location
16221 W. 159TH Street
Lockport, IL 60441-7959
Mailing address
16221 W. 159TH Street
Lockport, IL 60441-7959
Phone (815) 588-1111
Other names 1
- Lockport Express Medical Group
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120709000676 | IL | Part B Supplier - Clinic/Group Practice | 8628233053 |
Receives reassigned benefits from 17 practitioners Practice locations: Lockport, IL |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D2036421 | Lockport Express Medical Group | Certificate of waiver | Feb 6, 2028 |
National Provider Directory
National Provider DirectoryLocations
16427 W 159th St
Lockport, IL 60441
Phone (815) 588-1111
Practitioners & affiliated clinicians
Practitioners 17
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323216000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1370304000000",
"number": "1790053643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16221 W. 159TH STREET",
"city": "LOCKPORT",
"state": "IL",
"postal_code": "604417959",
"telephone_number": "815-588-1111",
"fax_number": "815-838-4305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16221 W. 159TH STREET",
"city": "LOCKPORT",
"state": "IL",
"postal_code": "604417959",
"telephone_number": "815-588-1111",
"fax_number": "815-838-4305"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LOCKPORT EXPRESS MEDICAL GROUP, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2011-12-07",
"last_updated": "2013-06-04",
"status": "A",
"authorized_official_last_name": "HANNA",
"authorized_official_first_name": "NAGUI",
"authorized_official_middle_name": "Y",
"authorized_official_title_or_position": "PHYSICIAN/OWNER",
"authorized_official_telephone_number": "630-960-1658",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "261QU0200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Urgent Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Lockport Express Medical Group",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Lockport, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2013; 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.