Individual provider Active NPI

Bahij Kreidieh

  • Clinical Cardiac Electrophysiology Physician
  • Evergreen Park, IL
National Provider Identifier
1023462280
Registry record updated Aug 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
036166973 Issued in IL
Practice address
3545 W 95TH St
Evergreen Park, IL 60805-2135
Phone
(708) 346-5562
Fax
(708) 346-2059
NPI assigned
Apr 14, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X 80790 AZ
Clinical Cardiac Electrophysiology Physician 207RC0001X 036166973 IL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

3545 W 95TH St
Evergreen Park, IL 60805-2135

Mailing address

100 E Lancaster Ave
Wynnewood, PA 19096-3450
Phone (844) 762-6824

Other practice location 1

1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone (928) 226-6400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240814003499 IL Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 3779964903 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Consultants in Cardiology and Electrophysiololgy LLCGroup PAC ID 4880779727, 21 clinicians

Practice addresses (Care Compare)

3545 W 95TH St
Evergreen Park, IL 60805-2135
Phone (708) 346-5562

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair30

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036166973ILMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Consultants in Cardiology & Electrophysiololgy LLC Clinical Cardiac Electrophysiology CurrentSince Aug 1, 2024 Accepting new patients

Locations

3545 W 95th St
Evergreen Pk, IL 60805
Phone (708) 435-9036

43 Orland Square Dr
Orland Park, IL 60462

15300 West Ave
Ste 23
Orland Park, IL 60462
Phone (708) 576-8150

Interoperability endpoints

  • Direct secure messaging: bkreidieh406461@direct.myadvocateaurora.org

Organizations & group practices 1

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.

Hospital & facility affiliations 5

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": "1460592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787270400000",
    "number": "1023462280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "844-762-6824",
            "fax_number": "561-548-1572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3545 W 95TH ST",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052135",
            "telephone_number": "708-346-5562",
            "fax_number": "708-346-2059"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 N Beaver St",
            "address_purpose": "LOCATION",
            "city": "Flagstaff",
            "state": "AZ",
            "postal_code": "860013118",
            "country_code": "US",
            "telephone_number": "928-226-6400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KREIDIEH",
        "first_name": "BAHIJ",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-14",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "AZ",
            "license": "80790",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "IL",
            "license": "036166973",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen Park, IL

Sources for this page

Verify at the official NPI Registry.