NPIMap

Individual provider Active NPI

Abdul-Hamid Mohammed Shahbain, MD

  • Internal Medicine Physician
  • Palos Heights, IL
National Provider Identifier
1023032646
Registry record updated May 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036085113 Issued in IL
Practice address
12508 S Harlem Ave
Suite C
Palos Heights, IL 60463-1597
Phone
(708) 671-1685
Fax
(708) 671-1695
NPI assigned
Jul 27, 2006
Last updated
May 21, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036085113 IL Primary

Addresses

Primary practice location

12508 S Harlem Ave
Suite C
Palos Heights, IL 60463-1597

Mailing address

12508 S Harlem Ave
Suite C
Palos Heights, IL 60463-1597
Phone (708) 671-1685

Other identifiers 2

IdentifierTypeStateIssuer
01633951OtherILBCBS
036085113MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040408000059 IL Practitioner - Internal Medicine 1951394881 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Shahbain Internal Medicine LTDGroup PAC ID 9537152459, 2 clinicians

Practice addresses (Care Compare)

12251 S 80TH Ave
Palos Heights, IL 60463-1290
Phone (708) 361-4500

12508 S Harlem Ave
Suite C
Palos Heights, IL 60463-1598
Phone (708) 671-1685

1890 Silver Cross Blvd
Suite 550
New Lenox, IL 60451-9579
Phone (708) 671-1685

1900 Silver Cross Blvd
New Lenox, IL 60451-9509
Phone (815) 740-1100

219 Bedford Rd
Morris, IL 60450-1442
Phone (708) 671-1685

7850 W College Dr
Palos Heights, IL 60463-1010
Phone (708) 361-6990

7880 W College Dr
Palos Heights, IL 60463-1010
Phone (708) 361-8070

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036085113ILMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: ashahbain275991@direct.myadvocateaurora.org

Organizations & group practices 2

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

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211328000000",
    "number": "1023032646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12508 S HARLEM AVE",
            "address_2": "SUITE C",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631597",
            "telephone_number": "708-671-1685",
            "fax_number": "708-671-1695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12508 S HARLEM AVE",
            "address_2": "SUITE C",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631597",
            "telephone_number": "708-671-1685",
            "fax_number": "708-671-1695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHBAIN",
        "first_name": "ABDUL-HAMID",
        "middle_name": "MOHAMMED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2008-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036085113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01633951",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036085113",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

Verify at the official NPI Registry.