MIRSHED MEDICAL CENTER S C
NPI 1083880637
Internal Medicine in Chicago, IL

Q: What is Mirshed Medical Center S C's NPI number?

The NPI number for Mirshed Medical Center S C is 1083880637. It was assigned to this organization in the NPPES registry on May 5, 2008.

Q: What is Mirshed Medical Center S C's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since May 05, 2008CLIA 14D1084213 · Waiver

4255 W 63RD ST, CHICAGO, IL 60629(773) 424-4048(773) 424-6463 Get Directions Write a Review

NPPES record last updated: November 5, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mirshed Medical Center S C NPPES

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

MIRSHED MEDICAL CENTER S C (NPI 1083880637) is a healthcare organization registered as an internal medicine in Chicago, Illinois and active in the NPI registry since May 2008. The organization holds a CLIA Waiver certificate valid through May 18, 2028 and lists Nayeh Edwin Mirshed, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1083880637

Entity TypeOrganization

Primary Taxonomy207R00000X

Legal Business NameMIRSHED MEDICAL CENTER S C

Location Address4255 W 63RD STChicago, IL 60629-5041

Mailing Address4255 W 63rd StChicago, IL 60629-5041 · (773) 424-4048 · Fax (773) 424-6463

Phone(773) 424-4048

Fax(773) 424-6463

Organization SubpartNo

Authorized OfficialNayeh Edwin MirshedExecutive Director · (773) 424-4048

Enumeration DateMay 5, 2008

Last NPPES UpdateNovember 5, 2008

✔ NPI 1083880637 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in IL · 036-091913

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

4255 W 63RD ST, Chicago, IL 60629

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Other Identifiers 1

Medicare PIN216880IL

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D1084213

Mirshed Medical Center S C · Chicago, IL

Active · expires May 18, 2028

CLIA Number14D1084213

Laboratory TypePhysician Office

Certificate Effective DateMay 19, 2026

Certificate Expiration DateMay 18, 2028

Laboratory DirectorNayeh E. Mirshed

Laboratory Phone(773) 424-4048

Laboratory LocationMirshed Medical Center S C4255 W 63rd Street, Chicago, IL 60629

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHERMI V PARIKH DPM

Podiatrist