NPIMap

Individual provider Active NPI

Shazia Daudi, MD

  • Internal Medicine Physician
  • Huntley, IL
National Provider Identifier
1235137928
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036111912 Issued in IL
Practice address
12151 Regency Pkwy Ste 12165
Huntley, IL 60142-7644
Phone
(847) 230-9808
Fax
(847) 984-1915
NPI assigned
Jul 7, 2005
Last updated
Nov 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036111912 IL Primary

Addresses

Primary practice location

12151 Regency Pkwy Ste 12165
Huntley, IL 60142-7644

Mailing address

12151 Regency Pkwy Ste 12165
Huntley, IL 60142-7644
Phone (847) 230-9808

Other identifiers 1

IdentifierTypeStateIssuer
036111912MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address drdaudi@direct.practicefusion.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041001001006 IL Practitioner - Internal Medicine 0749259083 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
SSD Medical Group IncGroup PAC ID 9032487244, 2 clinicians

Practice addresses (Care Compare)

12151 Regency Pkwy
Suite 12165
Huntley, IL 60142-7644
Phone (847) 230-9808

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
SSD Medical Group Inc Internal Medicine CurrentSince May 3, 2017 Accepting new patients

Locations

2400 Big Timber Rd
Ste 200
Elgin, IL 60124
Phone (847) 628-4751

12151 Regency Pkwy
Ste 12165
Huntley, IL 60142
Phone (847) 230-9808

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1235137928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12151 REGENCY PKWY STE 12165",
            "city": "HUNTLEY",
            "state": "IL",
            "postal_code": "601427644",
            "telephone_number": "847-230-9808",
            "fax_number": "847-984-1915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12151 REGENCY PKWY STE 12165",
            "city": "HUNTLEY",
            "state": "IL",
            "postal_code": "601427644",
            "telephone_number": "847-230-9808",
            "fax_number": "847-984-1915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUDI",
        "first_name": "SHAZIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036111912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036111912",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drdaudi@direct.practicefusion.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12151 Regency Pkwy Ste 12165",
            "city": "Huntley",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601427644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntley, IL

Sources for this page

Verify at the official NPI Registry.