NPIMap

Organization Active NPI

Midwest Express Care 2, Inc

Doing business as Midwest Express Clinic

  • Urgent Care Clinic/Center
  • Chicago, IL
National Provider Identifier
1902647894
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
MIDWEST EXPRESS CARE 2, INC
Doing business as
Midwest Express Clinic
Practice address
3333 W Fullerton Ave
Chicago, IL 60647-2513
Phone
(773) 257-0610
Fax
(312) 500-5037
NPI assigned
Jun 4, 2024
Last updated
Jun 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Authorized official

Name
Milap Shah
Title
Owner
Phone
(219) 802-8800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU Primary

Addresses

Primary practice location

3333 W Fullerton Ave
Chicago, IL 60647-2513

Mailing address

3333 W Fullerton Ave
Chicago, IL 60647-2513
Phone (773) 257-0610

Other names 1

  • Midwest Express Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250416001944 IL DME Supplier - Physician - Family Practice 0547495467 Practice locations: Chicago, IL

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2299205Midwest Express Clinic - Logan Square3333 W Fullerton Ave - Unit B, Chicago, IL 60647Certificate of waiverFeb 14, 2028

National Provider Directory

National Provider Directory

Locations

3333 W Fullerton Ave
Chicago, IL 60647
Phone (773) 257-0610

NPI Registry JSON

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

{
    "created_epoch": "1717459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1902647894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472513",
            "telephone_number": "773-257-0610",
            "fax_number": "312-500-5037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472513",
            "telephone_number": "773-257-0610",
            "fax_number": "312-500-5037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST EXPRESS CARE 2, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "MILAP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "219-802-8800"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midwest Express Clinic",
            "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 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.