Provider Demographics
NPI:1245053404
Name:CHICAGO MEDICAL FMR LLC
Entity type:Organization
Organization Name:CHICAGO MEDICAL FMR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FATIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAEED
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:331-775-4461
Mailing Address - Street 1:1000 GRAND CANYON PKWY STE 201
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-1730
Mailing Address - Country:US
Mailing Address - Phone:630-273-7004
Mailing Address - Fax:630-273-7432
Practice Address - Street 1:1000 GRAND CANYON PKWY STE 201
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-1730
Practice Address - Country:US
Practice Address - Phone:630-273-7004
Practice Address - Fax:630-273-7432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental