Individual provider Active NPI

Haitham Ramadan, PT, MS

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1013089093
Registry record updated Dec 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7000816 Issued in IL
Practice address
5693 S Archer Ave
Chicago, IL 60638-1655
Phone
(773) 284-0888
Fax
(773) 284-0880
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 7000816 IL Primary

Addresses

Primary practice location

5693 S Archer Ave
Chicago, IL 60638-1655

Mailing address

5764 S Archer Ave
Chicago, IL 60638-1643
Phone (773) 284-0888

Other identifiers 1

IdentifierTypeStateIssuer
7203613OtherILAETENA PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
7000816ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Home Health Advantage, Inc. CurrentSince May 3, 2016 Accepting new patients
Home Health Advantage, Inc. Current Accepting new patients
Abc Home Health Care, Inc PastSince Sep 12, 2011 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513036800000",
    "number": "1013089093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5764 S ARCHER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606381643",
            "telephone_number": "773-284-0888",
            "fax_number": "773-284-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5693 S ARCHER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606381655",
            "telephone_number": "773-284-0888",
            "fax_number": "773-284-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMADAN",
        "first_name": "HAITHAM",
        "credential": "PT, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2017-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "7000816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETENA PROVIDER NUMBER",
            "identifier": "7203613",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.