Provider Demographics
NPI:1043204852
Name:MID-AMERICA RHEUMATOLOGY CONSULTANTS
Entity type:Organization
Organization Name:MID-AMERICA RHEUMATOLOGY CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:THERESE
Authorized Official - Last Name:CHLADEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-661-9980
Mailing Address - Street 1:5701 W 119TH ST
Mailing Address - Street 2:SUITE 209
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-3722
Mailing Address - Country:US
Mailing Address - Phone:913-661-9980
Mailing Address - Fax:913-661-9173
Practice Address - Street 1:5701 W 119TH ST
Practice Address - Street 2:SUITE 209
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-3722
Practice Address - Country:US
Practice Address - Phone:913-661-9980
Practice Address - Fax:913-661-9173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-07
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No332900000XSuppliersNon-Pharmacy Dispensing Site
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS6380000Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER