63Rd Medical & Surgical Center, LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

63RD MEDICAL & SURGICAL CENTER, LLC

Practice address

3918 W 63Rd St
Chicago, IL 60629-4604

Phone

(773) 284-9660

Fax

(773) 284-9676

NPI assigned

Mar 2, 2017

Last updated

Mar 8, 2017By 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. Ayoub Sayeg, M.D.

Title

Medical Director

Phone

(773) 284-9660

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1488412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488931200000",
    "number": "1912447442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11232",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606110232",
            "telephone_number": "773-284-9660",
            "fax_number": "773-284-9676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3918 W 63RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606294604",
            "telephone_number": "773-284-9660",
            "fax_number": "773-284-9676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "63RD MEDICAL & SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-02",
        "last_updated": "2017-03-08",
        "status": "A",
        "authorized_official_last_name": "SAYEG",
        "authorized_official_first_name": "AYOUB",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "773-284-9660",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; 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.