Afsoon Karimi, MD
Individual provider Active NPI Pediatrics Physician · Darien, IL
NPI 1144299256 · NPPES record last updated Aug 13, 2013
Key facts
- NPI
- 1144299256
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 036110016 (IL)
- Practice address
- 1617 Laurel LN
Darien, IL 60561-5327 - Phone
- (312) 371-7958
- Fax
- (708) 345-8965
- NPI assigned
- Mar 14, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070928000427 | IL | Practitioner - Pediatric Medicine | 1153416680 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036110016 | IL | MD | Child Abuse Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Broadway Medical Center | Current |
Accepting new patients | |
| Metro Healthcare, SC | Past |
Accepting new patients |
Locations
4009 Warren Ave
Bellwood, IL 60104
Phone (708) 343-1300
Interoperability endpoints
- karimi.afsoon.006.0130085@bmc.meditab.direct-ci.com
- karimi.afsoon.003.0130085@bmc.meditab.direct-ci.com
- karimi.afsoon.007.0130085@bmc.meditab.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 036110016 | IL | Yes |
| Child Abuse Pediatrics Physician | 2080C0008X | 036110016 | IL |
Addresses
Primary practice location
1617 Laurel LN
Darien, IL 60561-5327
Mailing address
1617 Laurel LN
Darien, IL 60561-5327
Phone (312) 371-7958
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036110016 | Medicaid | IL | |
| 07215036 | Other | IL | BCBS |
Other providers in Darien, IL
- Joliet Oncology Hematology Associates, LTD.
- Brittany Jonauskas
- Deepa Mathew Joseph
- Rasik Joshi
- Juliette a. Valeriano, MD & Associates, LTD
- Suzanne Klucher Kasang
- Belsam Renee Kashlan
- Kasper,Heaton,Wright,Pagni,Andassociates,LTD.
- Kats Eye Care, P.C.
- Paul L Kats
All providers in Darien, IL · Pediatrics Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.