ILLINOIS MEDICAL GROUP SC (NPI# 1649219007) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649219007 |
| Entity Type | Organization |
| Organization Name | ILLINOIS MEDICAL GROUP SC |
| Practice Address |
4211 N Cicero Ave Chicago IL 60641-1651 |
| Practice Telephone | 7735456900 |
| Practice Fax Number | 7736852481 |
| Mailing Telephone | 7735456900 |
| Mailing Fax Number | 7736852481 |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2008-06-12 |
| Authorized Official Name | DR. SARMED G ELIAS (PRESIDENT) |
| Authorized Official Telephone | 7735456900 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
042618822 | IL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MEDICARE RAILROAD | DG1734 | 01 |
| Street Address |
4211 N CICERO AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60641-1651 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366444184 | Jack C. Enter Jr. | Physician Assistant | 4211 N Cicero Ave, Suite 100, Chicago, IL 60641-1651 | 2005-08-11 |
| 1205378460 | Caroline Rodriguez | Nurse Practitioner | 4211 N Cicero Ave, Chicago, IL 60641-1651 | 2016-11-04 |
| 1114342037 | Lauren Kimberly Hofius | Specialist/Technologist, Other | 4211 N Cicero Ave, #400, Chicago, IL 60641-1651 | 2014-02-28 |
| 1477892917 | Jacob M Richey | Podiatrist | 4211 N Cicero Ave, Chicago, IL 60641-1651 | 2013-02-04 |
| 1558611624 | Sophia Zamudio Rasof | Family Medicine | 4211 N Cicero Ave, Suite 308, Chicago, IL 60641-1651 | 2012-09-14 |
| 1265792212 | Sonia Shah M D S C | Internal Medicine | 4211 N Cicero Ave, Suite 203, Chicago, IL 60641-1651 | 2012-05-24 |
| 1740585736 | Chandra B Rathod Mdsc | Clinic/Center | 4211 N Cicero Ave, Suite 203, Chicago, IL 60641-1651 | 2011-01-21 |
| 1538460134 | Six Corners Anesthesia LLC | Anesthesiology | 4211 N Cicero Ave, Suite 400, Chicago, IL 60641-1651 | 2010-11-12 |
| 1720225469 | Diana Barros | Physician Assistant | 4211 N Cicero Ave, Suite #200, Chicago, IL 60641-1651 | 2009-01-16 |
| 1801055777 | Gerard P Alleje | Physical Therapist | 4211 N Cicero Ave, Suite #200, Chicago, IL 60641-1651 | 2008-06-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063038131 | Victoria Carmen Grau Kazmierzcak | Student in an Organized Health Care Education/Training Program | 5458 W Grace St, Unit 2, Chicago, IL 60641 | 2020-06-24 |
| 1659926921 | Farah Alhaidar | Counselor | 4028 W Irving Park Rd Loft B, Chicago, IL 60641 | 2019-08-05 |
| 1255898482 | Bernadeta Agnieszka Kapustka | Nurse Practitioner | 5425 W Addison, Chicago, IL 60641 | 2019-02-24 |
| 1295200921 | The Dental Masters of Belmont, LLC | Dentist | 5236 W. Belmont Ave., Chicago, IL 60641 | 2018-10-09 |
| 1700364171 | National Vision Inc | Technician/Technologist | 4068 North Milwaukee Avenue, Chicago, IL 60641 | 2018-07-30 |
| 1477055168 | Elaine Vozar Acupuncturist Ltd | Acupuncturist | 3817 N. Pulaski, Chicago, IL 60641 | 2018-03-08 |
| 1174906853 | Heather Rocco | Hearing Instrument Specialist | 4122 N Millwaukee Ave, Chicago, IL 60641 | 2015-06-30 |
| 1770910184 | Kendra Manning | Physician Assistant | 4959 W. Belmont Ave, Chicago, IL 60641 | 2013-09-30 |
| 1679916274 | Don E Mccree | Technician, Cardiology | 2936 N. Kolmar, 3c, Chicago, IL 60641 | 2013-04-12 |
| 1053664888 | Scott P Dusenbery | Occupational Therapist | 3235 N Lockwood Apt 3, Chicago, IL 60641 | 2012-10-17 |
| Find all providers in zip 60641 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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|---|---|---|---|---|
| 1861024176 | Mount Sinai Community Foundation | Clinic/Center | 1414 S Fairfield, Chicago, IL 60608 | 2020-02-05 |
| 1104460922 | Infinite Care Home Physicians LLC | Clinic/Center | 6044 N Nassau Ave, Chicago, IL 60631-2649 | 2019-11-05 |
| 1962051607 | Wilkes Post Acute Care Inc | Clinic/Center | 400 W 76th St Ste 303, Chicago, IL 60620-1640 | 2019-09-05 |
| 1861964959 | Midway Medical | Clinic/Center | 2 W 103rd St, Chicago, IL 60628-2619 | 2018-12-30 |
| 1043727571 | The Board of Trustees of The University of Illinois | Clinic/Center | 835 S. Wolcott, Suite E-144; Mc 684, Chicago, IL 60612 | 2018-01-05 |
| 1386099562 | Healthworks Medical Group of Illinois S C | Clinic/Center | Gem Building 723, 1st Floor, Touhy & Mt Prospect Rd, Chicago, IL 60666 | 2016-04-26 |
| 1235584475 | Healthworks Medical Group of Illinois S C | Clinic/Center | Terminal 3, K19 Concourse, Ramp Level Rm 100, Touhy & Mt Prospect Rd, Chicago, IL 60666 | 2016-04-25 |
| 1689904039 | Prime Care Medical and Physical Therapy Centers, S.c. | Clinic/Center | 1719 W 18th St, Chicago, IL 60608-1913 | 2010-01-07 |
| 1790938249 | Healing Hands Resource Center | Clinic/Center | 3143 W Douglas Blvd, Chicago, IL 60623-1816 | 2008-10-28 |
| 1770739591 | Alivio Medical Center Inc | Clinic/Center | 3120 S Kostner Ave, Chicago, IL 60623-4842 | 2008-08-12 |
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| 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.