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Unknown Imtiyaz Pasha

Physician β€’ Chicago, IL

Active NPI 1962141895 Individual Practitioner Male Practitioner
Practice location in NPPES

4539 N Sheridan Rd
Chicago, IL 606405618

Call 7734327187 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

4539 N Sheridan Rd

Chicago, IL 606405618

Telephone 7734327187
Organization at the Same NPPES Address or Phone

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 2 distinct additional practice-address records in Chicago, IL. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

NPI first issued

2022

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2022-08-26
Clinical Medical Laboratory Primary Specialty

NUCC Taxonomy Code: 291U00000X

(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Illinois Department of Financial and Professional Regulation.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Other Identifier License
14D2557061 (IL)

Secondary Practice Locations

6759 N Clark St

Chicago, IL 606263220

Phone: 7734327187

3448 N Clark St

Chicago, IL 606571610

Phone: 7737661090

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

8 Historical Events
🏒
Secondary Practice Location Registered August 26, 2022

Additional practice office at 3448 N Clark St, Chicago, IL 606571610

🏒
Secondary Practice Location Registered August 26, 2022

Additional practice office at 6759 N Clark St, Chicago, IL 606263220

βœ…
NPI Profile Active June 09, 2022

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) June 09, 2022

Registered at 4539 N SHERIDAN RD, CHICAGO, IL 606405618 (Tel: 7737661090)

πŸ“
Business Mailing Address (Initial Record) June 09, 2022

Registered at 6759 N CLARK ST, CHICAGO, IL 606263220 (Tel: 7737661090)

πŸ‘€
Provider Name / Credentials (Initial Record) June 09, 2022

Recorded as UNKNOWN IMTIYAZ PASHA

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) June 09, 2022

Clinical Medical Laboratory

🟒
Initial NPI Registration & Enumeration May 31, 2022

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1962141895
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 31, 2022
Last Update: August 26, 2022
Sole Proprietor: Yes

Mailing Address

6759 N Clark St

Chicago, IL 606263220

Phone: 7734327187

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.