MAMANATANDATHERNIZAMPC. (NPI# 1104134915) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104134915 |
| Entity Type | Organization |
| Organization Name | MAMANATANDATHERNIZAMPC. |
| Practice Address |
2001 W.69thst. Chicago IL 60636 |
| Mailing Address |
401 Tamerton Pkwy Burr Ridge IL 60527-6347 |
| Practice Telephone | 7737782355 |
| Practice Fax Number | 7737882355 |
| Mailing Telephone | 6306541021 |
| Mailing Fax Number | 7737882355 |
| Enumeration Date | 2010-09-15 |
| Last Update Date | 2010-09-15 |
| Authorized Official Name | DR. MAIMANAT NIZAM (PHYSICIAN) |
| Authorized Official Telephone | 6306541021 |
| Authorized Official Credential | MD. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QC1500X |
Clinic/Center Specialization: Community Health |
036-06-9635 | IL | Ambulatory Health Care Facilities |
| Street Address |
2001 W.69THST. |
| City | CHICAGO |
| State | IL |
| Zip Code | 60636 |
| 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 |
| 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 |
| 1427344100 | Neil P Parikh | Dentist | 5843 S Western Ave, Chicago, IL 60636 | 2011-06-22 |
| Find all providers in zip 60636 | ||||
| Taxonomy Code | 261QC1500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Community Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609499573 | Nurse Now LLC | Clinic/Center | 2901 S Michigan Ave Apt 406, Chicago, IL 60616-3297 | 2020-05-26 |
| 1316356850 | The Night Ministry | Clinic/Center | 4711 N Ravenswood Ave, Chicago, IL 60640-4407 | 2014-08-08 |
| 1962664268 | Jil Medical Consultant | Clinic/Center | 5500 S Damen Ave, Chicago, IL 60636-1107 | 2008-06-27 |
| 1447418017 | Health Department | Clinic/Center | 5400 S Hyde Park Blvd Apt D2, Chicago, IL 60615-5852 | 2008-05-29 |
| 1295947430 | Communityhealth | Clinic/Center | 2611 W Chicago Ave, Chicago, IL 60622-4519 | 2007-05-03 |
| 1649399106 | Circle Family Healthcare Network, Inc | Clinic/Center | 115 Parkside, Chicago, IL 60644-3040 | 2007-03-28 |
| 1194819623 | City of Chicago | Clinic/Center | South Lawndale Nhc, 3059 W 26th Street, Chicago, IL 66023 | 2006-10-02 |
| 1194817809 | New Hope Community Service | Clinic/Center | 2011 E 75th St Ste 110, Chicago, IL 60649-3646 | 2006-09-29 |
| 1871595256 | City of Chicago | Clinic/Center | 641 W 63rd St, Chicago, IL 60621-2032 | 2005-08-15 |
| 1194717330 | City of Chicago | Clinic/Center | South Chicago, 2938 E 89th Street, Chicago, IL 60617 | 2005-08-15 |
| 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.