Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

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

Q: 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.

Q: What is Mamanatandathernizampc.'s specialty?

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

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: November 6, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

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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

Last NPPES UpdateNovember 6, 2026

✔ 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

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 November 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 days 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.