Selah Medical Group S.C

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

036-116775 Issued in IL

Legal business name

SELAH MEDICAL GROUP S.C

Practice address

927 N Plum Grove Rd
Schaumburg, IL 60173-5171

Phone

(630) 945-7797

NPI assigned

Jan 23, 2014

Last updated

Feb 13, 2014By 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. Victor Olawale Mensah, M.D

Title

Medical Director/Ceo

Phone

(630) 945-7797

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1390435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392249600000",
    "number": "1972926145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4160 WILLIAMS CT",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601921407",
            "telephone_number": "630-945-7797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 N PLUM GROVE RD",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601735171",
            "telephone_number": "630-945-7797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELAH MEDICAL GROUP S.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-23",
        "last_updated": "2014-02-13",
        "status": "A",
        "authorized_official_last_name": "MENSAH",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "OLAWALE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR/CEO",
        "authorized_official_telephone_number": "630-945-7797",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "IL",
            "license": "036-116775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Schaumburg, IL
• Providers in Schaumburg, 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 Feb 13, 2014; 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.