Organization Active NPI

Mir Akif Ali MD PC

  • General Practice Physician
  • Chicago, IL
National Provider Identifier
1952520504
Registry record updated Dec 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
036047763 Issued in IL
Legal business name
MIR AKIF ALI MD PC
Practice address
2400 W Devon Ave
Ste# 213
Chicago, IL 60659-1910
Phone
(630) 941-5295
Fax
(773) 279-6515
NPI assigned
Apr 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2015

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

Authorized official

Name
Dr. Mir Akif Ali, MD PC
Title
Owner
Phone
(630) 276-8282

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X 036047763 IL Primary

Addresses

Primary practice location

2400 W Devon Ave
Ste# 213
Chicago, IL 60659-1910

Mailing address

2400 W Devon Ave
Ste# 213
Chicago, IL 60659-1910
Phone (630) 941-5295

Other identifiers 2

IdentifierTypeStateIssuer
036047763MedicaidIL
01622104OtherILBCBS

National Provider Directory

National Provider Directory

Locations

2400 W Devon Ave
Ste 210
Chicago, IL 60659
Phone (630) 941-5295

2400 W Devon Ave
Ste 213
Chicago, IL 60659
Phone (773) 277-6589

2400 W Devon Ave
Chicago, IL 60659
Phone (773) 279-4957

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450310400000",
    "number": "1952520504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 W DEVON AVE",
            "address_2": "STE# 213",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606591910",
            "telephone_number": "630-941-5295",
            "fax_number": "773-279-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 W DEVON AVE",
            "address_2": "STE# 213",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606591910",
            "telephone_number": "630-941-5295",
            "fax_number": "773-279-6515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIR AKIF ALI MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2015-12-17",
        "status": "A",
        "authorized_official_last_name": "ALI",
        "authorized_official_first_name": "MIR",
        "authorized_official_middle_name": "AKIF",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-276-8282",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD PC"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "IL",
            "license": "036047763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036047763",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01622104",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Dec 17, 2015; 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.