Midway Medical

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

MIDWAY MEDICAL

Practice address

2 W 103Rd St
Chicago, IL 60628-2619

Phone

(773) 597-7698

NPI assigned

Dec 30, 2018

Last updated

Jul 22, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marvin Cok

Title

Staff

Phone

(773) 597-7698

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1546128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626912000000",
    "number": "1861964959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 W 103RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606282619",
            "telephone_number": "773-597-7698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 W 103RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606282619",
            "telephone_number": "773-597-7698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWAY MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-30",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A",
        "authorized_official_last_name": "COK",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_title_or_position": "STAFF",
        "authorized_official_telephone_number": "773-597-7698"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Midway Diagnostic Center LTD
• Midway Disc and Spine Center (Osteorthritis Center of Forest Park)
• Midway Family Dental, LLC (63 Family Dental)
• Midway Foot and Ankle PC
• Midway Health Inc
• Midway Medical Center (Midway Turning Point Center)
• Midway Medical Center
• Midway Pediatrics LLC
• Midway Pediatrics LLC
• Midway Spine and Joint Pain Physicians

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; 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.