Northwest Medical and Urgent Care Center at Madison LTD

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

NORTHWEST MEDICAL AND URGENT CARE CENTER AT MADISON LTD

Practice address

3171 W Madison St
Chicago, IL 60612-1809

Phone

(773) 362-4648

NPI assigned

Nov 10, 2017

Last updated

Oct 24, 2018By 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

Dr. Mohammad Khamis, MD

Title

President/Ceo

Phone

(773) 362-4648

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1510272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540339200000",
    "number": "1881107902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5352 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606252316",
            "telephone_number": "773-353-5047",
            "fax_number": "773-353-2406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3171 W MADISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606121809",
            "telephone_number": "773-362-4648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST MEDICAL AND URGENT CARE CENTER AT MADISON LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-10",
        "last_updated": "2018-10-24",
        "status": "A",
        "authorized_official_last_name": "KHAMIS",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "773-362-4648",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036112029",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northwest ENT Associates, S.C.
• Northwest General Surgeons LTD
• Northwest Health Care, LTD
• Northwest Home Care, Inc. (Abcor Home Health, Inc.)
• Northwest Labs LLC
• Northwest Medical and Urgent Care Center at South Shore LLC
• Northwest Medical and Urgent Care Center at Yale and 95TH LTD
• Northwest Medical Associates of Chicago LLC
• Northwest Medical Foundation Inc
• Northwest Medical Imaging

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2018; 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.