Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Grand Medical Clinic, Inc

Organization Surgery Physician · NPI 1457658841

Grand Medical Clinic, Inc provides Surgery Physician services in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2011.

Licensed in
IL
In the registry since
2011
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2158 W Grand Ave Ste 101
Chicago, IL 60612-1571 Not confirmed with CMS for 15 years — call before visiting
Phone: (312) 733-9858
Fax: (312) 799-8661
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 036124389 (IL)

Record details

NPI number1457658841
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Omar Garcia — Owner · (312) 733-9858
NPI enumeratedFebruary 21, 2011
Last updated in NPPESFebruary 21, 2011
Mailing address2158 W Grand Ave, Suite 101, Chicago, IL 60612-1571

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