NPIMap

Organization Active NPI

Lockport Express Medical Group, Inc.

Doing business as Lockport Express Medical Group

  • Urgent Care Clinic/Center
  • Lockport, IL
National Provider Identifier
1790053643
Registry record updated Jun 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
LOCKPORT EXPRESS MEDICAL GROUP, INC.
Doing business as
Lockport Express Medical Group
Practice address
16221 W. 159TH Street
Lockport, IL 60441-7959
Phone
(815) 588-1111
Fax
(815) 838-4305
NPI assigned
Dec 7, 2011
Last updated
Jun 4, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2013

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.NPI 1477578920
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)CodeLicenseStatePrimary
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 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 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
14D2036421Lockport Express Medical Group16221 West 159TH St, Lockport, IL 60441Certificate of waiverFeb 6, 2028

National Provider Directory

National Provider Directory

Locations

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, and the practitioner matching its NPPES authorized official.

View all 17

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.

Verify at the official NPI Registry.