BROADWAY MEDICAL GROUP (NPI# 1306952858) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306952858 |
| Entity Type | Organization |
| Organization Name | BROADWAY MEDICAL GROUP |
| Practice Address |
4826 N. Broadway Chicago IL 60640 |
| Mailing Address |
4826 N Broadway St Chicago IL 60640-3604 |
| Practice Telephone | 7732758333 |
| Practice Fax Number | 7732759297 |
| Mailing Telephone | 7732758333 |
| Mailing Fax Number | 7732759297 |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2010-04-13 |
| Authorized Official Name | K.J. J PHILIP (OWNER) |
| Authorized Official Telephone | 8474756063 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 173000000X | Legal Medicine | 036110420 | IL | Other Service Providers |
| Street Address |
4826 N. BROADWAY |
| City | CHICAGO |
| State | IL |
| Zip Code | 60640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336754233 | Rci (wrs), LLC. | Clinic/Center | 5221-23 North Broadway, Chicago, IL 60640 | 2020-09-09 |
| 1548871916 | Borici Counseling LLC | Counselor | 4731 N Paulina St, Chicago, IL 60640 | 2020-08-11 |
| 1306319173 | Gerardo Garcia | Physician Assistant | Medical Staff Office, Weiss Memorial Hospital, 4646 N Marine Drive, Chicago, IL 60640 | 2019-01-04 |
| 1386121283 | Aea Optical Ventures, LLC | Clinic/Center | 4814 N Clark St, Chicago, IL 60640 | 2018-07-24 |
| 1023503885 | Lauren Vassiliades | Internal Medicine | Weiss Memorial Hospital, Medical Education Dpt., 4646 N. Marine Drive, C Elevators, 7th Flr. # 7100, Chicago, IL 60640 | 2018-06-25 |
| 1477061620 | Yesenia Vargas | Nurse Practitioner | 1025 W Sunnyside, Chicago, IL 60640 | 2018-01-22 |
| 1932622206 | Jasleen Kaur Brar | Internal Medicine | 4646 N. Marine Dr., Chicago, IL 60640 | 2017-07-19 |
| 1750802849 | Umer Mukhtar | Internal Medicine | 4646 N. Marine Dr. Med Ed Dept. C Elevators., Weiss Memorial Hospital. 7 Floor. #7100, Chicago, IL 60640 | 2017-06-29 |
| 1184144081 | Ellie Navidson | Registered Nurse | 1015 W Lawrence, 2nd Floor, Chicago, IL 60640 | 2017-06-21 |
| 1962932558 | Jennifer Stridh | Marriage & Family Therapist | 5125 N. Winthrop Ave, 1f, Chicago, IL 60640 | 2017-06-15 |
| Find all providers in zip 60640 | ||||
| Taxonomy Code | 173000000X |
| Grouping | Other Service Providers |
| Classification | Legal Medicine |
| The specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical examinations at crime scenes, performance of autopsies, giving of expert medical testimony in judicial proceedings, medical treatment of inmates of penal institutions, the practice of trauma medicine in law enforcement settings, and other clinical practice and medical science applications in the fields of law, law enforcement, and corrections. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992934673 | Remegio M Vilbar Mdsc | Legal Medicine | 1431 N Western Ave Ste 202, Chicago, IL 60622-7712 | 2009-07-02 |
| 1467669200 | Chicago North Medical Partnership | Legal Medicine | 5308 N Broadway St, Chicago, IL 60640-2312 | 2007-05-17 |
| 1306915319 | Aleksy Dobradin | Legal Medicine | 6422 W Belmont Ave, Chicago, IL 60634-3921 | 2006-11-06 |
| 1124060645 | Miroslaw Piotrowski | Legal Medicine | 5912 S Archer Ave, Chicago, IL 60638-2803 | 2006-06-11 |
| 1033159090 | Midway Diagnostic Center Ltd | Legal Medicine | 5261 S Cicero Ave, Chicago, IL 60632-4915 | 2006-06-07 |
| 1437105947 | Pediatrics & Dermatology Sc | Legal Medicine | 6211 N Milwaukee Ave, Chicago, IL 60646-3730 | 2006-05-26 |
| 1033164025 | Ad Medical Ltd. | Legal Medicine | 6422 W. Belmont Ave, Chicago, IL 60634-3921 | 2006-05-24 |
| 1033163563 | Bohdan Fedirko | Legal Medicine | 5255 S Cicero Ave, Chicago, IL 60632-4915 | 2006-05-20 |
| 1013980507 | Laeh Esther Litin | Legal Medicine | 3633 N California Ave, Chicago, IL 60618-4602 | 2006-02-07 |
| 1104285741 | Paul Schnoll Mesnick | Legal Medicine | 1530 N Dearborn Pkwy, Chicago, IL 60610-1446 | 2016-02-10 |
| 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.