KHUDEIRA MEDICAL CENTER, INC (NPI# 1720332703) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720332703 |
| Entity Type | Organization |
| Organization Name | KHUDEIRA MEDICAL CENTER, INC |
| Practice Address |
8071 S Cicero Ave Chicago IL 60652-2003 |
| Mailing Address |
9405 S Oketo Ave Bridgeview IL 60455-2140 |
| Practice Telephone | 7735850480 |
| Practice Fax Number | 7735850482 |
| Mailing Telephone | 7735850480 |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2019-02-01 |
| Authorized Official Name | ABDULKAREEM KHUDEIRA (OWNER) |
| Authorized Official Telephone | 7735850480 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036-085737 | 05 |
| Street Address |
8071 S CICERO AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60652-2003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538105911 | Abdulkareem Khudeira | Internal Medicine | 8071 S Cicero Ave, Chicago, IL 60652-2003 | 2006-06-22 |
| 1114425618 | Neda Khudeira | Dietitian, Registered | 8071 S Cicero Ave, Chicago, IL 60652-2003 | 2018-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861042715 | New Hope Community Service Center | Clinic/Center | New Hope Community Service Center, 2559 West 79th, Chicago, IL 60652 | 2019-09-12 |
| 1770012189 | Rachel Pasternak | Social Worker | 3348 W 87th Street, Chicago, IL 60652 | 2017-06-08 |
| 1437682283 | Manliu Yang | Dentist | 8541 S Cicero Ave, Chicago, IL 60652 | 2017-04-08 |
| 1336687144 | Stephanie J. Wilson | Registered Nurse | 7600 S. Pulask Rd., Chicago, IL 60652 | 2017-02-01 |
| 1346786811 | Talisha Moman | Licensed Practical Nurse | 7600 S. Pulaski Rd., Suite 1106, Chicago, IL 60652 | 2017-01-09 |
| 1952851933 | Yvonne Caldwell | Licensed Practical Nurse | 8600 S. Pulaski, Road, Chicago, IL 60652 | 2016-10-13 |
| 1942605795 | Brittney Mclean | Developmental Therapist | 4317 W. 77th Pl, Chicago, IL 60652 | 2014-10-22 |
| 1245599521 | Chisa Marie Collins | Occupational Therapist | 8008 S Albany, Chicago, IL 60652 | 2012-05-08 |
| 1548572969 | St. Mary Therapy Services | Clinic/Center | 2455 W 79th St, #101, Chicago, IL 60652 | 2010-07-14 |
| 1750574752 | Curt R Lang | Dentist | 4651 W 79th St, Suite 208, Chicago, IL 60652 | 2007-08-22 |
| Find all providers in zip 60652 | ||||
| Taxonomy Code | 261QU0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Urgent Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245880715 | Familydoc Urgent Care LLC | Clinic/Center | 7201 S Stony Island Ave, Chicago, IL 60649 | 2019-09-17 |
| 1003385535 | Midwest Express Care 2 Inc | Clinic/Center | 3258 W 111th St, Chicago, IL 60655-2729 | 2018-11-14 |
| 1215302971 | Medspring of Texas, Pa | Clinic/Center | 779 Adams, Chicago, IL 60661-0000 | 2015-12-07 |
| 1255722120 | Medspring of Texas, Pa | Clinic/Center | 3301 N Ashland Ave, Chicago, IL 60657-2127 | 2015-02-12 |
| 1942690672 | Northwestern Memorial Healthcare | Clinic/Center | 1030 N Wolcott Ave, Chicago, IL 60622-5986 | 2015-02-03 |
| 1376941849 | Medspring of Texas, Pa | Clinic/Center | 219 W Chicago Ave, Chicago, IL 60654-5600 | 2014-12-15 |
| 1790030385 | Hometown Urgent Care of Michigan, P.C. | Clinic/Center | 7483 Solutions Ctr, Chicago, IL 60677-7004 | 2012-07-19 |
| 1811256043 | Immediate M.d., LLC | Clinic/Center | 2037 N Clybourn Ave, Chicago, IL 60614-4003 | 2012-05-08 |
| 1003084112 | South Loop Urgent Care, LLC | Clinic/Center | 1430 S Michigan Ave, C2, Chicago, IL 60605-2960 | 2008-02-12 |
| 1316136955 | American Current Care of Illinois PC | Clinic/Center | 1230 West Lake Street, Chicago, IL 60607-1602 | 2007-10-19 |
| Find all providers in CHICAGO | ||||
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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.