SOUTH SUBURBAN MEDICAL CLINIC LLC (NPI# 1750532420) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750532420 |
| Entity Type | Organization |
| Organization Name | SOUTH SUBURBAN MEDICAL CLINIC LLC |
| Practice Address |
3800 W 203rd St Suite 201 Olympia Fields IL 60461-1184 |
| Practice Telephone | 7087489952 |
| Practice Fax Number | 7087489924 |
| Mailing Telephone | 7087489952 |
| Mailing Fax Number | 7087489924 |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2010-01-11 |
| Authorized Official Name | NADEEM AHMAD (OWNER) |
| Authorized Official Telephone | 7087489952 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 036103449 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | INDIVIDUAL NPI | 1700868023 | 01 |
| IL | 036103449 | 05 |
| Street Address |
3800 W 203RD ST SUITE 201 |
| City | OLYMPIA FIELDS |
| State | IL |
| Zip Code | 60461-1184 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306828140 | Barbara Zeng Kwasny | Nurse Practitioner | 3800 W 203rd St, Olympia Fields, IL 60461-1184 | 2005-11-17 |
| 1518583491 | Stephanie Ward | Nurse Practitioner | 3800 W 203rd St, Olympia Fields, IL 60461-1184 | 2020-06-17 |
| 1184089351 | Andrea Cashman Duerinck | Nurse Practitioner | 3800 W 203rd St, Olympia Fields, IL 60461-1184 | 2015-12-15 |
| 1932523362 | Pulmonary and Sleep Associates Inc. | Clinic/Center | 3800 W 203rd St, Suite 201, Olympia Fields, IL 60461-1184 | 2014-02-05 |
| 1114357845 | Suburban Infectious Disease LLC | General Acute Care Hospital | 3800 W 203rd St, Suite 201, Olympia Fields, IL 60461 | 2013-11-15 |
| 1538504493 | Hassan George Azar | Internal Medicine | 3800 W 203rd St, Suite 202, Olympia Fields, IL 60461-1184 | 2013-05-06 |
| 1366716185 | St James Hospital United States Catholic Conference | Internal Medicine | 3800 W 203rd St, Suite 202, Olympia Fields, IL 60461-1184 | 2012-02-24 |
| 1669635223 | Frankfort Medical Clinic | Internal Medicine | 3800 W 203rd St, Suite 201, Olympia Fields, IL 60461-1184 | 2008-07-03 |
| 1790976231 | Midwest Physician Group Ltd | Nurse Practitioner | 3800 W 203rd St, Olympia Fields, IL 60461-1184 | 2007-08-08 |
| 1972640654 | Midwest Physician Group Ltd | Internal Medicine | 3800 W 203rd St, Suite 202, Olympia Fields, IL 60461-1184 | 2007-01-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609372564 | Katherine Gill Haddad | Student in an Organized Health Care Education/Training Program | 20201 S. Crawford Avenue, Attn: Postdoctoral Education, Olympia Fields, IL 60461 | 2018-03-31 |
| 1750886610 | Kim Minh Dang | Student in an Organized Health Care Education/Training Program | 20201 South Crawford, Olympia Fields, IL 60461 | 2018-03-23 |
| 1619484110 | Alexandra N. Douvas | Dentist | 20180 Governors Hwy, Ste 104, Olympia Fields, IL 60461 | 2018-01-05 |
| 1992258438 | Krystyne Doty | Nurse Practitioner | 3800 W 203rd St Ste 209, Olympia Fields, IL 60461 | 2016-08-02 |
| 1205286747 | Shirlene Umali | Registered Nurse | 20201 South Crawford Ave, Olympia Fields, IL 60461 | 2016-06-15 |
| 1386002590 | Touch of Wholeness Psychological Services, LLC | Psychologist | 20280 Governors Dr, Suite 207, Olympia Fields, IL 60461 | 2016-02-02 |
| 1063895357 | David Dardick | Dentist | 20180 Governors Hwy Ste 104, Olympia Fields, IL 60461 | 2015-07-04 |
| 1811378623 | Fins Healthcare Agency | Nursing Care | 3612 Lincohn Highway, Suite 19, Olympia Fields, IL 60461 | 2015-06-17 |
| 1285048959 | Garud Ranga Raj | Orthopaedic Surgery | 20817 Alexander St, Olympia Fields, IL 60461 | 2014-06-20 |
| 1811316334 | Brett Hapeman | Emergency Medicine | 20201 S Crawford, Attn: Postdoctoral Education, Olympia Fields, IL 60461 | 2014-04-11 |
| Find all providers in zip 60461 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841511532 | Michael Patrick Hollandsworth | Internal Medicine | 20303 Crawford Ave Ste 110, Attn: Marsha Cronkite, Olympia Fields, IL 60461-1173 | 2010-06-16 |
| 1063543346 | Edward Joseph Winter | Internal Medicine | 20945 Cambridge Ln, Olympia Fields, IL 60461-1832 | 2007-03-08 |
| 1588618060 | Rita N. Oganwu M.d.s.c. | Internal Medicine | 20303 S Crawford Ave Ste 110, Olympia Fields, IL 60461 | 2006-05-20 |
| 1467405472 | Julie R Brandies | Internal Medicine | 4001 Vollmer Rd, Olympia Fields, IL 60461-3168 | 2006-05-19 |
| 1194385351 | Dixita Patel | Internal Medicine | 20201 Crawford Ave, Olympia Fields, IL 60461-1010 | 2019-06-19 |
| 1003476268 | Chintan Shah | Internal Medicine | 20201 Crawford Ave, Olympia Fields, IL 60461-1010 | 2019-06-19 |
| 1023472321 | Kyle Kleist | Internal Medicine | 20201 Crawford Ave, Olympia Fields, IL 60461-1010 | 2016-04-12 |
| 1346626041 | Brian Randolph Dyson | Internal Medicine | 20201 Crawford Ave, Olympia Fields, IL 60461 | 2015-08-04 |
| 1528473790 | Umair Randhawa | Internal Medicine | 20201 Crawford Ave, Olympia Fields, IL 60461-1010 | 2014-06-26 |
| 1639584279 | Faithful Osarekpama Osawe | Internal Medicine | 20201 Crawford Ave, Olympia Fields, IL 60461 | 2014-06-23 |
| Find all providers in OLYMPIA FIELDS | ||||
| City | OLYMPIA FIELDS |
| Zip Code | 60461 |
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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.