Active NPI
Salim Kassam, MD
- Family Medicine Physician
- Calumet City, IL
National Provider Identifier
1063517035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Practice address
- 1756 Sibley Blvd
Calumet City, IL 60409-2215 - Phone
- (708) 730-3900
- Fax
- (773) 637-2006
- NPI assigned
- Sep 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | IL | Primary |
Addresses
Primary practice location
1756 Sibley Blvd
Calumet City, IL 60409-2215
Mailing address
1756 Sibley Blvd
Calumet City, IL 60409-2215
Phone (708) 730-3900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01605103 | Other | IL | BLUE SHIELD OF IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200268800000",
"number": "1063517035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1756 SIBLEY BLVD",
"city": "CALUMET CITY",
"state": "IL",
"postal_code": "604092215",
"telephone_number": "708-730-3900",
"fax_number": "773-637-2006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1756 SIBLEY BLVD",
"city": "CALUMET CITY",
"state": "IL",
"postal_code": "604092215",
"telephone_number": "708-730-3900",
"fax_number": "773-637-2006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KASSAM",
"first_name": "SALIM",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-14",
"last_updated": "2008-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD OF IL",
"identifier": "01605103",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Calumet City, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.