NPIMap

Organization Active NPI

M & R Rudra Incorporated

Doing business as New Life Medical Center

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1831372044
Registry record updated Jun 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038009513 Issued in IL
Legal business name
M & R RUDRA INCORPORATED
Doing business as
New Life Medical Center
Practice address
4111 W 26TH St
Ste 110
Chicago, IL 60623-4313
Phone
(773) 542-1111
Fax
(773) 542-7100
NPI assigned
Dec 11, 2007
Last updated
Jun 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2008

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

Authorized official

Name
Dr. Manish D Pandya, DCNPI 1467498022
Title
President
Phone
(630) 965-2225

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 038009513 IL Primary

Addresses

Primary practice location

4111 W 26TH St
Ste 110
Chicago, IL 60623-4313

Mailing address

4111 W 26TH St
Ste 110
Chicago, IL 60623-4313
Phone (773) 542-1111

Other names 1

  • New Life Medical Center Doing business as

National Provider Directory

National Provider Directory

Locations

4111 W 26th St
#110
Chicago, IL 60623
Phone (773) 542-1111

4111 W 26th St
Ste 110
Chicago, IL 60623
Phone (773) 542-1111

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213315200000",
    "number": "1831372044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 W 26TH ST",
            "address_2": "STE 110",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606234313",
            "telephone_number": "773-542-1111",
            "fax_number": "773-542-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 W 26TH ST",
            "address_2": "STE 110",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606234313",
            "telephone_number": "773-542-1111",
            "fax_number": "773-542-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M & R RUDRA INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-11",
        "last_updated": "2008-06-13",
        "status": "A",
        "authorized_official_last_name": "PANDYA",
        "authorized_official_first_name": "MANISH",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-965-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038009513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Life Medical 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 13, 2008; 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.