Individual provider Active NPI

Tahreer Shatat, DO

  • Family Medicine Physician
  • Frankfort, IL
National Provider Identifier
1245677749
Registry record updated Feb 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036139062 Issued in IL
Practice address
23120 S Lagrange Rd
Frankfort, IL 60423-7760
Phone
(815) 464-5440
Fax
(815) 936-5404
NPI assigned
May 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036139062 IL Primary

Addresses

Primary practice location

23120 S Lagrange Rd
Frankfort, IL 60423-7760

Mailing address

23120 S Lagrange Rd
Frankfort, IL 60423-7760
Phone (815) 464-5440

Other identifiers 1

IdentifierTypeStateIssuer
036139062MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160804000590 IL Practitioner - Family Practice 0143446534 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Midwestern University, Chicago College of Osteopathic Med, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7 Blanchard Cir
Suite 102
Wheaton, IL 60189-2038

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Feb 1, 2020 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Feb 1, 2020 Accepting new patients
Riverside Health System CurrentSince Aug 29, 2016 Accepting new patients
Riverside Health System CurrentSince Aug 29, 2016 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

23120 S Lagrange Rd
Frankfort, IL 60423
Phone (815) 464-5440

23120 S Lagrange Rd
Ste 200
Frankfort, IL 60423
Phone (815) 464-5440

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

611 S Division St
Peotone, IL 60468
Phone (708) 258-9058

7 Blanchard Cir
Ste 102
Wheaton, IL 60189
Phone (630) 510-9009

105 S First St
Wilmington, IL 60481
Phone (815) 476-5210

Organizations & group practices 4

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 2

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": "1369353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549411200000",
    "number": "1245677749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23120 S LAGRANGE RD",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604237760",
            "telephone_number": "815-464-5440",
            "fax_number": "815-936-5404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23120 S LAGRANGE RD",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604237760",
            "telephone_number": "815-464-5440",
            "fax_number": "815-936-5404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHATAT",
        "first_name": "TAHREER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-24",
        "last_updated": "2019-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036139062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036139062",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frankfort, IL

Sources for this page

Verify at the official NPI Registry.