Roselle Physical Medicine Group

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

Legal business name

ROSELLE PHYSICAL MEDICINE GROUP

Practice address

50 E Irving Park Rd
Roselle, IL 60172-2050

Phone

(630) 295-8851

Fax

(630) 295-8852

NPI assigned

Jul 24, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Tariq Ahmed, DC

Title

President

Phone

(630) 295-8851

Specialties & licenses 3

Addresses

Tax ID family

Roselle Physical Medicine Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Roselle Physical Medicine Group

  • Chiropractor
  • Roselle, IL
  • NPI 1255720975
  NPD tax ID

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

{
    "created_epoch": "1437696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437696000000",
    "number": "1851776439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 E IRVING PARK RD",
            "city": "ROSELLE",
            "state": "IL",
            "postal_code": "601722050",
            "telephone_number": "630-295-8851",
            "fax_number": "630-295-8852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 E IRVING PARK RD",
            "city": "ROSELLE",
            "state": "IL",
            "postal_code": "601722050",
            "telephone_number": "630-295-8851",
            "fax_number": "630-295-8852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSELLE PHYSICAL MEDICINE GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-24",
        "last_updated": "2015-07-24",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "TARIQ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-295-8851",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "364SA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rophe Wound Care PLLC
• Rose of Sharon MC LLC
• Roselle Chiropractic Inc
• Roselle Dental Center PC
• Roselle Physical Medicine Group
• Roselle School Dist 12
• Roselle Service Company LLC
• Royal Marketing and Lead Generation
• Patricia Deselm Rummelhart
• S & J Scooter Supply

• Sports Medicine (Family Medicine) Physician in Roselle, IL
• Providers in Roselle, IL by specialty
• Sports Medicine (Family Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2015; 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.