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MARYMINA RESPIRATORY MEDICINE, LLC
NPI 1083851174
Internal Medicine - Pulmonary Disease in Washington, IL

Active since January 12, 2009
1740 SYCAMORE, WASHINGTON, IL 61571(309) 360-4879 Get Directions Write a Review

NPPES record last updated: July 10, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Marymina Respiratory Medicine, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARYMINA RESPIRATORY MEDICINE, LLC (NPI 1083851174) is a healthcare organization registered as a pulmonary disease in Washington, Illinois and active in the NPI registry since January 2009. The organization lists Ossama Ikladios, President, as its authorized official.

NPPES Registry Identity

NPI1083851174
Entity TypeOrganization
Primary Taxonomy207RP1001X
Legal Business NameMARYMINA RESPIRATORY MEDICINE, LLC
Location Address1740 SYCAMOREWashington, IL 61571-9799
Mailing Address1740 SycamoreWashington, IL 61571-9799 · (309) 360-4879
Phone(309) 360-4879
Organization SubpartNo
Authorized OfficialOssama IkladiosPresident · (309) 360-4879
Enumeration DateJanuary 12, 2009
Last NPPES UpdateJuly 10, 2011
✔ NPI 1083851174 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License✔ Licensed in NJ · 025MA069176
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
1740 SYCAMORE, Washington, IL 61571
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Other Identifiers 3

Medicare UPING95025
Medicaid8065403NJ
Medicare PIN027938

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Marymina Respiratory Medicine, LLC's NPI number?

The NPI number for Marymina Respiratory Medicine, LLC is 1083851174. It was assigned to this organization in the NPPES registry on January 12, 2009.

Where is Marymina Respiratory Medicine, LLC located?

Marymina Respiratory Medicine, LLC is located at 1740 Sycamore, Washington, IL 61571. The listed phone number is (309) 360-4879.

What is Marymina Respiratory Medicine, LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

When was this NPI record last updated?

The NPPES record for Marymina Respiratory Medicine, LLC was last updated on July 10, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.