MGM Medical Associates, LTD. SC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036104910 Issued in IL

Legal business name

MGM MEDICAL ASSOCIATES, LTD. SC

Practice address

2425 W 22ND St
Suite: 211
Oak Brook, IL 60523-1245

Phone

(630) 368-3909

Fax

(630) 368-3958

NPI assigned

Sep 21, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Meera George Madappallil, M.D.NPI 1699721142

Title

President

Phone

(847) 414-4460

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Meera George Madappallil, M.D.

  • Internal Medicine Physician
  • Oak Brook, IL
  • NPI 1699721142
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429660800000",
    "number": "1982703856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8345 W MAYNARD RD",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607141058",
            "telephone_number": "847-983-4215",
            "fax_number": "847-983-9215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 W 22ND ST",
            "address_2": "SUITE: 211",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231245",
            "telephone_number": "630-368-3909",
            "fax_number": "630-368-3958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MGM MEDICAL ASSOCIATES, LTD. SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2015-04-22",
        "status": "A",
        "authorized_official_last_name": "MADAPPALLIL",
        "authorized_official_first_name": "MEERA",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-414-4460",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036104910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmine Menser-Lust, LCPC
• Meridian Hospice (Advocate Hospice)
• Bruce Richard Metcalf, D.D.S.
• Christopher Andrew Metcalf, D.D.S.
• Corinne S Meyer, PT
• Michael K Odonoghue MD LTD
• Elizabeth Michaels, D.O.
• Melissa Michalewicz
• Joshua Michel
• Midwest Center for Hope & Healing

• Internal Medicine Physician in Oak Brook, IL
• Providers in Oak Brook, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.