Active NPI
Mohammed Abdul Basith, MD
- Surgical Assistant
- Glendale Heights, IL
National Provider Identifier
1154070233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 238.000747
- Practice address
- 2043 Audubon Dr
Glendale Heights, IL 60139-1807 - Phone
- (602) 399-4983
- NPI assigned
- Mar 23, 2022
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 238.000747 | IL | Primary |
Addresses
Primary practice location
2043 Audubon Dr
Glendale Heights, IL 60139-1807
Mailing address
2043 Audubon Dr
Glendale Heights, IL 60139-1807
Phone (602) 399-4983
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 238.000747 | IL | MD | Surgical Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647993600000",
"number": "1154070233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2043 AUDUBON DR",
"city": "GLENDALE HEIGHTS",
"state": "IL",
"postal_code": "601391807",
"telephone_number": "602-399-4983"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2043 AUDUBON DR",
"city": "GLENDALE HEIGHTS",
"state": "IL",
"postal_code": "601391807",
"telephone_number": "602-399-4983"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASITH",
"first_name": "MOHAMMED",
"middle_name": "ABDUL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-23",
"last_updated": "2022-03-23",
"certification_date": "2022-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "IL",
"license": "238.000747",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale Heights, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.