NPIMap

Individual provider Active NPI

Shahab Kazi, DO

  • Emergency Medicine Physician
  • Libertyville, IL
National Provider Identifier
1194306894
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036.168277 Issued in IL
Practice address
801 S Milwaukee Ave
Libertyville, IL 60048-3204
Phone
(847) 362-2900
NPI assigned
Apr 15, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 81843-21 WI
Emergency Medicine Physician 207P00000X 036.168277 IL Primary

Addresses

Primary practice location

801 S Milwaukee Ave
Libertyville, IL 60048-3204

Mailing address

801 S Milwaukee Ave
Libertyville, IL 60048-3204
Phone (847) 362-2900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240808002482 IL Practitioner - Emergency Medicine 6103283858 Reassigns benefits to 1 organization
I20250813002755 WI Practitioner - Emergency Medicine 6103283858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vituity-Wisconsin Em SCGroup PAC ID 2466814538, 56 clinicians
Cepamerica Illinois LLPGroup PAC ID 3274793633, 492 clinicians

Practice addresses (Care Compare)

3100 Superior Ave
Sheboygan, WI 53081-1948
Phone (920) 459-8300

801 S Milwaukee Ave
Libertyville, IL 60048-3204
Phone (847) 990-5300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.41 of 100Reported as group
Quality
86.81
Improvement activities
40
Cost
77.34

Merit-based Incentive Payment System (MIPS)

Final score
82.39 of 100Reported as group
Quality
68.19
Promoting interoperability
83
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.168277ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cepamerica Illinois LLP Emergency Medicine CurrentSince Jul 4, 2024 Accepting new patients
Vituity-Wisconsin Em SC Emergency Medicine CurrentSince Jul 30, 2025 Accepting new patients
Vituity-Wisconsin Em SC Emergency Medicine Current Accepting new patients
Cepamerica Illinois LLP Emergency Medicine CurrentSince Jul 4, 2024 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine Current Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1425 N Randall Rd
Elgin, IL 60123
Phone (224) 783-5437

801 S Milwaukee Ave
Libertyville, IL 60048
Phone (847) 362-2900

9555 76th St
Pleasant Prairie, WI 53158
Phone (262) 577-8000

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

Organizations & group practices 5

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 5

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": "1618444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1194306894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S MILWAUKEE AVE",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483204",
            "telephone_number": "847-362-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S MILWAUKEE AVE",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483204",
            "telephone_number": "847-362-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAZI",
        "first_name": "SHAHAB",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-15",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "81843-21",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036.168277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

Verify at the official NPI Registry.