NPIMap

Individual provider Active NPI

Osama Khairy Atieh, M.D.

  • Internal Medicine Physician
  • Palos Heights, IL
National Provider Identifier
1083821565
Registry record updated Dec 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036086966 Issued in IL
Practice address
12050 S Harlem Ave
Unit B
Palos Heights, IL 60463-1470
Phone
(708) 361-5788
Fax
(708) 361-5508
NPI assigned
May 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2021

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 036086966 IL Primary

Addresses

Primary practice location

12050 S Harlem Ave
Unit B
Palos Heights, IL 60463-1470

Mailing address

12050 S Harlem Ave
Unit B
Palos Heights, IL 60463-1470
Phone (708) 361-5788

Other identifiers 1

IdentifierTypeStateIssuer
036086966MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address oatieh283173@direct.myadvocateaurora.org Direct
FHIR URL https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20050603000139 IL Practitioner - Internal Medicine 5294778064 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Rush Medical College of Rush University, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

12050 S Harlem Ave
Suite B
Palos Heights, IL 60463-2083
Phone (708) 361-5788

Hospital & facility affiliations

  • Palos Community Hospital Home Health Care Home health agency, Lemont, IL, CCN 147470
  • Advocate Christ Hospital & Medical Center Hospital, Oak Lawn, IL, CCN 140208
  • Palos Community Hospital Hospital, Palos Heights, IL, CCN 140062
  • Silver Cross Hospital and Medical Centers Hospital, New Lenox, IL, CCN 140213
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036086966ILMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: oatieh283173@direct.myadvocateaurora.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/JIICCA/Endpoint/JIICCA

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 9

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": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1083821565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12050 S HARLEM AVE",
            "address_2": "UNIT B",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631470",
            "telephone_number": "708-361-5788",
            "fax_number": "708-361-5508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12050 S HARLEM AVE",
            "address_2": "UNIT B",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631470",
            "telephone_number": "708-361-5788",
            "fax_number": "708-361-5508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATIEH",
        "first_name": "OSAMA",
        "middle_name": "KHAIRY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036086966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036086966",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "oatieh283173@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "12050 S Harlem Ave",
            "address_2": "Unit B",
            "city": "Palos Heights",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604631470",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "12050 S Harlem Ave",
            "address_2": "Unit B",
            "city": "Palos Heights",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604631470",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

Verify at the official NPI Registry.