MEDICARE: MIDWEST MEDICAL SYSTEMS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	036111540	IL
2	207R00000X	Internal Medicine Physician	036-087-821	IL
3	261QP2000X	Physical Therapy Clinic/Center	070-002-882	IL
4	207RR0500X	Rheumatology Physician	036-087-821	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518064484
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIDWEST MEDICAL SYSTEMS INC

Provider Business Mailing Address
First Line	:	2309 BILTER RD
Second Line	:
City	:	AURORA
State	:	IL
Zip	:	60502-8714
Country	:	US
Telephone Number	:	630-428-3600
Fax Number	:	630-428-1710

Provider Business Practice Location Address
First Line	:	1177 N HIGHLAND AVE
Second Line	:	SUITE 201
City	:	AURORA
State	:	IL
Zip	:	60506-2281
Country	:	US
Telephone Number	:	630-801-7505
Fax Number	:	630-801-7511

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. GOWHAR KHAN
Credential	:	MD
Telephone Number	:	630-802-8644

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	04/11/2022

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Directions to “MIDWEST MEDICAL SYSTEMS INC ” Practice Location

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