Sibley Family Medical Center SC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036071269 Issued in IL

Legal business name

SIBLEY FAMILY MEDICAL CENTER SC

Practice address

1756 Sibley Blvd
Calumet City, IL 60409-2215

Phone

(708) 730-3900

Fax

(708) 730-7298

NPI assigned

May 27, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Salim Kassam, MD

Title

Owner

Phone

(708) 730-3900

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212969600000",
    "number": "1265690291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1756 SIBLEY BLVD",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604092215",
            "telephone_number": "708-730-3900",
            "fax_number": "708-730-7298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1756 SIBLEY BLVD",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604092215",
            "telephone_number": "708-730-3900",
            "fax_number": "708-730-7298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIBLEY FAMILY MEDICAL CENTER SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-27",
        "last_updated": "2008-06-09",
        "status": "A",
        "authorized_official_last_name": "KASSAM",
        "authorized_official_first_name": "SALIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-730-3900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036071269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036071269",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Calumet City, IL
• Providers in Calumet City, 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 Jun 9, 2008; 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.