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Contact Information

MIDWAY MEDICAL CENTER
2 W 103RD ST
CHICAGO, IL60628-2619
 Phone: 313-489-4715
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Behavioral Health

251S00000X
 

Case Management

251B00000X
 

Clinical Medical Laboratory

291U00000X 69 Clinical Laboratory
 

Community Health

261QC1500X
 

Mental Health (Including Community Mental Health Center)

261QM0801X B4[14] Community Mental Health Center
 

Primary Care

261QP2300X
Indicates primary specialty

NPI Profile & details for MIDWAY MEDICAL CENTER

NPI # 1316545189
LBN Legal business name MIDWAY MEDICAL CENTER
Authorized official EUNICE WALKER - (DIRECTOR)
Entity Organization
Organization subpart 1 Yes
Enumeration date 10/14/2020
Last updated 10/21/2022 - About 4 years ago
Identifiers
IL Medicaid 6676700
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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