MIDWEST PHYSICIAN GROUP LTD (NPI# 1972640654) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972640654 |
| Entity Type | Organization |
| Organization Name | MIDWEST PHYSICIAN GROUP LTD |
| Other Organization Name | MPC-CARDIOVASCULAR INSTITUTE |
| Practice Address |
3800 W 203rd St Suite 202 Olympia Fields IL 60461-1184 |
| Mailing Address |
20110 Governors Hwy Olympia Fields IL 60461-1030 |
| Practice Telephone | 7087470461 |
| Practice Fax Number | 7087474704 |
| Mailing Telephone | 7087477960 |
| Mailing Fax Number | 7085033993 |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DEBORAH J NELSON (CEO) |
| Authorized Official Telephone | 7087477960 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS | 0001616617 | 01 |
| Other Name | Type Code |
|---|---|
| MPC-CARDIOVASCULAR INSTITUTE | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942494174 | Midwest Physician Group Ltd | Clinic/Center | 1051 Essington Road, Silver Cross Medical Center, Joliet, IL 60931 | 2007-08-30 |
| 1215074026 | Midwest Physician Group Ltd | Family Medicine | 13811 Cicero Ave, Crestwood, IL 60445-1826 | 2007-01-31 |
| 1053599167 | Midwest Physician Group Ltd | Clinic/Center | 20110 Governors Hwy, 1st Floor, Olympia Fields, IL 60461-1030 | 2008-01-31 |
| 1790976231 | Midwest Physician Group Ltd | Nurse Practitioner | 3800 W 203rd St, Olympia Fields, IL 60461-1184 | 2007-08-08 |
| 1104944214 | Midwest Physician Group Ltd | Clinic/Center | 4001 Vollmer Road, Olympia Fields, IL 60461 | 2007-03-27 |
| 1073650818 | Midwest Physician Group Ltd | Family Medicine | 595 William R Latham Sr Dr, Bourbonnais, IL 60914-2319 | 2007-01-31 |
| 1285771972 | Midwest Physician Group Ltd | Family Medicine | 4001 Vollmer Rd, Olympia Fields, IL 60461 | 2007-01-31 |
| 1073650560 | Midwest Physician Group Ltd | Family Medicine | 11250 S Western Ave, Chicago, IL 60643-4116 | 2007-01-31 |
| 1699812487 | Midwest Physician Group Ltd | Family Medicine | 3201 S Wallace St, Chicago, IL 60616-3501 | 2007-01-31 |
| 1639216435 | Midwest Physician Group Ltd | Family Medicine | 10242 S Vincennes Ave, Chicago, IL 60643-1301 | 2007-01-31 |
| Street Address |
3800 W 203RD ST SUITE 202 |
| 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 |
| 1750532420 | South Suburban Medical Clinic LLC | Internal Medicine | 3800 W 203rd St, Suite 201, Olympia Fields, IL 60461-1184 | 2008-09-30 |
| 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 |
| 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 | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://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 |
|---|---|---|---|---|
| 1124399605 | South Suburban Cardiology Associates, Ltd. | Internal Medicine | 20303 S Crawford Ave, Suite 120, Olympia Fields, IL 60461-1176 | 2012-01-16 |
| 1043203862 | Matthew L Kamin | Internal Medicine | 3800 W 203rd St Ste 204, Olympia Fields, IL 60461-1185 | 2005-08-26 |
| 1982609723 | Narayan Mulamalla | Internal Medicine | 3800 203rd St, Ste 209, Olympia Fields, IL 60461-1939 | 2005-06-17 |
| 1932342102 | Mohammad Shakir | Internal Medicine | 20201 Crawford Ave, Olympia Fields, IL 60461-1010 | 2009-04-16 |
| 1811162704 | Jelica Maze | Internal Medicine | 3800 W 203rd St Ste 204, Olympia Fields, IL 60461-1185 | 2008-04-23 |
| 1043329394 | Cardiovascular Care Associates S.c. | Internal Medicine | 3800 203rd St, Suite 209, Olympia Fields, IL 60461-1936 | 2006-08-30 |
| 1417967829 | Lawrence U Haspel | Internal Medicine | 3800 W 203rd St, Ste 202, Olympia Fields, IL 60461-1184 | 2006-08-08 |
| 1255370136 | Mohamad Martini | Internal Medicine | 3800 W 203rd St Ste 204, Olympia Fields, IL 60461 | 2006-06-06 |
| 1083668560 | Noel Camba | Internal Medicine | 3800 W 203rd St, Suite 204, Olympia Fields, IL 60461-1184 | 2006-05-20 |
| 1407812050 | Hassan Kieso | Internal Medicine | 3800 W 203rd St, Suite 204, Olympia Fields, IL 60461-1184 | 2006-04-24 |
| 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.