Avicenna Health Center Corp

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

AVICENNA HEALTH CENTER CORP

Practice address

10417 S Roberts Rd
Palos Hills, IL 60465-1931

Phone

(708) 307-9376

NPI assigned

Mar 3, 2021

Last updated

Mar 3, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Adham Badwan

Title

Owner

Phone

(708) 307-9376

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14258/brand/1/csg/1/fhir/r4

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shaban Beiram

  • Physical Therapist
  • Oak Lawn, IL
  • NPI 1497482889
  Medicare reassignment NPD
• Adam Halim, PT, DPT

  • Physical Therapist
  • Chicago, IL
  • NPI 1235852328
  Medicare reassignment NPD
• Othman O'Malley, DPT

  • Physical Therapist
  • Memphis, TN
  • NPI 1710476890
  NPD

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

{
    "created_epoch": "1614729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614729600000",
    "number": "1093300956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10417 S ROBERTS RD",
            "city": "PALOS HILLS",
            "state": "IL",
            "postal_code": "604651931",
            "telephone_number": "708-307-9376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10417 S ROBERTS RD",
            "city": "PALOS HILLS",
            "state": "IL",
            "postal_code": "604651931",
            "telephone_number": "708-307-9376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVICENNA HEALTH CENTER CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-03",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A",
        "authorized_official_last_name": "BADWAN",
        "authorized_official_first_name": "ADHAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-307-9376"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Joseph Astroth, D.C.
• Haya Attieh
• Sandeep K. Atwal, APN
• Avail Chiropractic LLC
• Avicenna Dental LLC
• Sara Awwad
• Glenn E Bailey, D.D.S.
• Vijay Bajaj, M.D.
• Gregg Randall Baker
• Jennifer Emily Baker, LCSW

• Physical Therapist in Palos Hills, IL
• Providers in Palos Hills, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.