| Iman | |
|
2744 W 63rd St Chicago IL 60629-2343 | |
| (773) 434-4626 | |
| (773) 776-3623 |
| Full Name | Iman |
|---|---|
| Speciality | Clinic/Center |
| Location | 2744 W 63rd St, Chicago, Illinois |
| Authorized Official Name and Position | Rami Nashashibi (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7734344626 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Iman 2744 W 63rd St Chicago IL 60629-2343 Ph: (773) 434-4626 | Iman 2744 W 63rd St Chicago IL 60629-2343 Ph: (773) 434-4626 |
| NPI Number | 1003244567 |
|---|---|
| Provider Enumeration Date | 10/21/2013 |
| Last Update Date | 05/02/2018 |
| Medicare PECOS PAC ID | 4183942212 |
|---|---|
| Medicare Enrollment ID | O20150421001140 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003244567 | NPI | - | NPPES |
| Provider Name | Shona Mairi Hillman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275570699 PECOS PAC ID: 6204829443 Enrollment ID: I20040405001202 |
| Provider Name | Naveed K Mallick |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033275615 PECOS PAC ID: 6305889114 Enrollment ID: I20050602000911 |
| Provider Name | Mohammed Altaf Kaiseruddin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164455978 PECOS PAC ID: 3072580919 Enrollment ID: I20061120000440 |
| Provider Name | Andi Arnautovic |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487795118 PECOS PAC ID: 9335299940 Enrollment ID: I20090602000404 |
| Provider Name | Sofia M Adawy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427283290 PECOS PAC ID: 5890949416 Enrollment ID: I20130207000442 |
| Provider Name | Joseph Quincy Lyon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922401819 PECOS PAC ID: 2062735087 Enrollment ID: I20141226000152 |
| Provider Name | Mubashir S Saeed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518221654 PECOS PAC ID: 7214228600 Enrollment ID: I20160615000172 |
| Provider Name | Aamair Tajuddin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1689916058 PECOS PAC ID: 8729355763 Enrollment ID: I20170523002992 |
| Provider Name | Sarah Haroon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639586472 PECOS PAC ID: 3375769698 Enrollment ID: I20170808001788 |
| Provider Name | Suzanne Z Chopra |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457890568 PECOS PAC ID: 7416221296 Enrollment ID: I20170918000976 |
| Provider Name | Ralph G. Ryan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548254972 PECOS PAC ID: 9739168832 Enrollment ID: I20171130001618 |
| Provider Name | Queennorah Anigbogu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962060566 PECOS PAC ID: 0042545022 Enrollment ID: I20190712001822 |
| Provider Name | Shan Rehman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841618691 PECOS PAC ID: 7315241106 Enrollment ID: I20190718002483 |
| Provider Name | Brittani M James |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164819215 PECOS PAC ID: 6406166743 Enrollment ID: I20190912000080 |
| Provider Name | Elizabette Nava |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861970642 PECOS PAC ID: 5597197145 Enrollment ID: I20191120000189 |
| Provider Name | Amanda E Wright |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033505045 PECOS PAC ID: 5092087643 Enrollment ID: I20200113001088 |
| Provider Name | Brendan Sullivan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144660754 PECOS PAC ID: 1355615568 Enrollment ID: I20210311001058 |
| Provider Name | Janki Rami |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982023453 PECOS PAC ID: 2163780263 Enrollment ID: I20210504002427 |
| Provider Name | Ramalaxmi Shanmugavelayutham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962998914 PECOS PAC ID: 3274932058 Enrollment ID: I20210527001167 |
| Provider Name | Hanit U Shah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366963332 PECOS PAC ID: 9133526858 Enrollment ID: I20210923000526 |
| Provider Name | Ebony Markin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194445734 PECOS PAC ID: 0042671190 Enrollment ID: I20230804002715 |
| Provider Name | Luther Walls |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851955462 PECOS PAC ID: 4688093164 Enrollment ID: I20230811003109 |
| Provider Name | Natali Y Rehman |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1558719344 PECOS PAC ID: 2264883719 Enrollment ID: I20240109001668 |
| Provider Name | Shannon B Mccray |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104365196 PECOS PAC ID: 1850743998 Enrollment ID: I20240115000198 |
| Provider Name | Sanna Stella |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477231884 PECOS PAC ID: 6305289729 Enrollment ID: I20240213000965 |
| Provider Name | Dwayne Arra Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811600745 PECOS PAC ID: 8628419587 Enrollment ID: I20240509003932 |
| Provider Name | Jessica Lynn Good |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437911310 PECOS PAC ID: 1254773476 Enrollment ID: I20240520002602 |
Philip K Mccullough Md Sc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 E Huron St, Suite 11-100, Chicago, IL 60611 Phone: 312-695-3680 Fax: 312-926-3709 | |
Amy Lynn, Lcpc, Atr Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3020 N Lincoln Ave, Flourish Studios, Chicago, IL 60657 Phone: 773-746-7429 | |
K.a.m Alliance, Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2215 W 95th St Ste 100, Chicago, IL 60643 Phone: 773-239-9600 Fax: 773-239-9601 | |
King Community Mental Health Center Corp Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4455 S King Drive, Suite 101, Chicago, IL 60653 Phone: 773-536-2700 Fax: 773-751-2250 | |
Young Adult Program Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4219 N Lincoln Ave, Chicago, IL 60618 Phone: 773-572-5500 Fax: 773-537-3488 | |
Professional Diagnostic Service, S.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 821 W Van Buren St, Chicago, IL 60607 Phone: 312-491-0404 Fax: 312-491-0505 | |
Universal Medical Group Ltd. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 809 E 42nd Pl, Chicago, IL 60653 Phone: 773-285-3422 |