MAIMANAT NIZAM


Address: 2001 W 69th St, Chicago, IL 60636-3262
Phone: 7737782355

MAIMANAT NIZAM (NPI# 1265579262) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1265579262
Entity Type Individual
Full Name MAIMANAT NIZAM
Credential M.D.
Practice Address 2001 W 69th St
Chicago
IL 60636-3262
Mailing Address 401 Tamerton Pkwy
Burr Ridge
IL 60527-6347
Practice Telephone 7737782355
Practice Fax Number 7737782355
Mailing Telephone 6306541021
Enumeration Date 2007-01-30
Last Update Date 2013-06-13
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207QA0505X Family Medicine
Specialization: Adult Medicine
036-069635 IL Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
IL 036069635 05

Office Location

Street Address 2001 W 69TH ST
City CHICAGO
State IL
Zip Code 60636-3262

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NPI Name Taxonomy Address Enumeration
1124438742 Habilitative Systems, Inc. Case Management 6845 S Western Ave, Chicago, IL 60636 2014-05-05
1346505286 Sneha Abichandani Pediatrics 5843 South Western, Chicago, IL 60636 2012-07-06
1972812501 Westwood Medical Ceter Inc Surgery 6326 S. Ashland Avenue, Chicago, IL 60636 2010-09-30
1104134915 Mamanatandathernizampc. Clinic/Center 2001 W.69thst., Chicago, IL 60636 2010-09-15
1295966562 Carla Maria Lennan Durable Medical Equipment & Medical Supplies 6343 S. Western, Chicago, IL 60636 2009-08-04
1083826507 Devere J Herron Dentist 7203 South Western Avenue, Chicago, IL 60636 2007-05-04
1427155910 Highland Park Cvs, L.L.C. Durable Medical Equipment & Medical Supplies 1620 West 59th St, Chicago, IL 60636 2006-09-19
1023031473 J &j Pharmacy Ltd. Pharmacist 2001 W 69th Street, Clinic Pharmacy, Chicago, IL 60636 2006-07-26
1831169218 Michael A. Luckett, Dmd & Associates (western Dentist 6153 South Western Avenue, Chicago, IL 60636 2006-01-26
1457330870 Friend Family Health Center, Inc Clinic/Center 5843 S. Western Avenue, Chicago, IL 60636 2006-01-13
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Taxonomy Information

Taxonomy Code 207QA0505X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine
Specialization Adult Medicine

Taxonomy Definition

Definition to come.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1043811425 Devon Homecare Physicians Inc. Family Medicine 2822 W. Granville Ave. Apt 1, Chicago, IL 60659 2020-11-03
1447666318 M & F Medical Services, Ltd Family Medicine 5642 N Christiana Ave, Chicago, IL 60659-4555 2014-07-10
1457767774 Rambha Radhakrishnan Family Medicine 2645 W Peterson Ave, Chicago, IL 60659-4017 2014-07-08
1730444639 Iqbal S Husain Family Medicine 6936 N Chicora Ave, Chicago, IL 60646-1508 2012-07-07
1033480413 Healthworks Integrative Medical Clinic Family Medicine 1165 N Clark St Ste 608, Chicago, IL 60610-7848 2012-01-18
1518123843 Nastane Le Bec Family Medicine 6225 S Kenwood Ave Apt 1s, Chicago, IL 60637-3766 2008-08-06
1639372410 Albert R Rosanova Jr Ltd Family Medicine 5510 W Montrose Ave, Chicago, IL 60641-1330 2007-06-07
1386860997 Mariya Dmytriv-kapeniak Family Medicine 2540 W Chicago Ave, Chicago, IL 60622-5019 2007-04-18
1255462578 Roberto Diaz Family Medicine 1805 S Ashland Ave, Chicago, IL 60608-2805 2007-03-08
1386784346 Carroll Edward Smith Family Medicine 4215 S King Dr, Chicago, IL 60653-2663 2007-02-07
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Competitor

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City CHICAGO
Zip Code 60636

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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