1093701187 NPI number — R.K. MEDICAL CENTER LTD

Table of content: (NPI 1093701187)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093701187 NPI number — R.K. MEDICAL CENTER LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
R.K. MEDICAL CENTER LTD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093701187
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/22/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 958722
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOFFMAN ESTATES
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60195-8722
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-490-6817
Provider Business Mailing Address Fax Number:
847-490-6819

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
959 W GOLF RD
Provider Second Line Business Practice Location Address:
959-963
Provider Business Practice Location Address City Name:
SCHAUMBURG
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60194-1329
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-490-6817
Provider Business Practice Location Address Fax Number:
847-490-6819
Provider Enumeration Date:
09/23/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
RAHIM
Authorized Official First Name:
AMINA
Authorized Official Middle Name:
M.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
847-490-6817

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  036087153 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)