Asad Redjai MD SC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

036053488 Issued in IL

Legal business name

ASAD REDJAI MD SC

Practice address

1945 W Wilson Ave
Suite 6120
Chicago, IL 60640-5255

Phone

(773) 784-5300

Fax

(773) 784-5391

NPI assigned

Feb 29, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Asad Redjai, MD SC

Title

President

Phone

(773) 784-5300

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1330473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330473600000",
    "number": "1861766404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1945 W WILSON AVE",
            "address_2": "SUITE 6120",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405255",
            "telephone_number": "773-784-5300",
            "fax_number": "773-784-5391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 W WILSON AVE",
            "address_2": "SUITE 6120",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405255",
            "telephone_number": "773-784-5300",
            "fax_number": "773-784-5391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASAD REDJAI MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-29",
        "last_updated": "2012-02-29",
        "status": "A",
        "authorized_official_last_name": "REDJAI",
        "authorized_official_first_name": "ASAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-784-5300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD SC"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "IL",
            "license": "036053488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036053488",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kesia Keiko Asami de Souza, DDS

• Medical Specialty Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Medical Specialty Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2012; 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.