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MAMANATANDATHERNIZAMPC.
NPI 1104134915
Clinic/Center - Community Health in Chicago, IL

Active since September 15, 2010
2001 W.69THST., CHICAGO, IL 60636(773) 778-2355(773) 788-2355 Get Directions Write a Review

NPPES record last updated: September 15, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mamanatandathernizampc. NPPES

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

MAMANATANDATHERNIZAMPC. (NPI 1104134915) is a healthcare organization registered as a community health in Chicago, Illinois and active in the NPI registry since September 2010. The organization lists Maimanat Nizam, Physician, as its authorized official.

NPPES Registry Identity

NPI1104134915
Entity TypeOrganization
Primary Taxonomy261QC1500X
Legal Business NameMAMANATANDATHERNIZAMPC.
Location Address2001 W.69THST.Chicago, IL 60636
Mailing Address401 Tamerton PkwyBurr Ridge, IL 60527-6347 · (630) 654-1021 · Fax (773) 788-2355
Phone(773) 778-2355
Fax(773) 788-2355
Organization SubpartNo
Authorized OfficialMaimanat NizamPhysician · (630) 654-1021
Enumeration DateSeptember 15, 2010
✔ NPI 1104134915 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Community HealthAmbulatory Health Care Facilities
Taxonomy Code261QC1500X
License✔ Licensed in IL · 036-06-9635
2001 W.69THST., Chicago, IL 60636
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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 Mamanatandathernizampc.'s NPI number?

The NPI number for Mamanatandathernizampc. is 1104134915. It was assigned to this organization in the NPPES registry on September 15, 2010.

Where is Mamanatandathernizampc. located?

Mamanatandathernizampc. is located at 2001 W.69thst., Chicago, IL 60636. The listed phone number is (773) 778-2355.

What is Mamanatandathernizampc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Community Health, with taxonomy code 261QC1500X.

When was this NPI record last updated?

The NPPES record for Mamanatandathernizampc. was last updated on September 15, 2010. 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.