Palos Heights Medical Center

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036052775 Issued in IL

Legal business name

PALOS HEIGHTS MEDICAL CENTER

Doing business as

shakir moiduddin

Practice address

7530 W College Dr
Suite C
Palos Heights, IL 60463-1196

Phone

(708) 361-0911

NPI assigned

Oct 15, 2007

Last updated

Oct 15, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Shakir Moiduddin, M.D.NPI 1295810547

Title

Medical Director

Phone

(708) 361-0911

Specialties & licenses 1

Addresses

Other names 1

• shakir moiduddin Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shakir Moiduddin, MD

  • Family Medicine Physician
  • Palos Heights, IL
  • NPI 1295810547
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192406400000",
    "number": "1245428374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7530 W COLLEGE DR",
            "address_2": "SUITE C",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631196",
            "telephone_number": "708-361-0911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7530 W COLLEGE DR",
            "address_2": "SUITE C",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631196",
            "telephone_number": "708-361-0911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALOS HEIGHTS MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-15",
        "last_updated": "2007-10-15",
        "status": "A",
        "authorized_official_last_name": "MOIDUDDIN",
        "authorized_official_first_name": "SHAKIR",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "708-361-0911",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036052775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "shakir moiduddin",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Palos Diagnostics SC
• Palos Emergency Medical Services, LTD
• Palos Family Dental LLC
• Palos Heights Dental Group, P.C.
• Palos Heights Fire Protection District
• Palos Heights School District 128
• Palos Heights Sleep Center LTD
• Palos Hills Pharmacy, Inc. (Hills Drug Palos)
• Palos Medical Care SC
• Palos Pain Center

• Family Medicine Physician in Palos Heights, IL
• Providers in Palos Heights, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.