Active NPI
Suroosh Hadi
- Home Health Agency
- Orland Park, IL
National Provider Identifier
1154977478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 1010891
- Practice address
- 62 Orland Square Dr Ste 203
Orland Park, IL 60462-6559 - Phone
- (708) 460-3235
- Fax
- (708) 460-3994
- NPI assigned
- Aug 13, 2019
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 1010891 | IL | Primary |
Addresses
Primary practice location
62 Orland Square Dr Ste 203
Orland Park, IL 60462-6559
Mailing address
62 Orland Square Dr Ste 203
Orland Park, IL 60462-6559
Phone (708) 460-3235
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1010891 | Other | IL | LICENSE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1010891 | IL | MD | Home Health Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565654400000",
"number": "1154977478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "62 ORLAND SQUARE DR STE 203",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604626559",
"telephone_number": "708-460-3235",
"fax_number": "708-460-3994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "62 ORLAND SQUARE DR STE 203",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604626559",
"telephone_number": "708-460-3235",
"fax_number": "708-460-3994"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HADI",
"first_name": "SUROOSH",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-13",
"last_updated": "2019-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "IL",
"license": "1010891",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "1010891",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orland Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.