Active NPI
Ahmad Faris, CSA
- Surgical Assistant
- Chicago, IL
National Provider Identifier
1265980916
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 238.000515
- Practice address
- 5145 N California Ave
Chicago, IL 60625-3661 - Phone
- (773) 878-8200
- Fax
- (773) 271-5090
- NPI assigned
- Sep 12, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 238.000515 | IL | Primary |
Addresses
Primary practice location
5145 N California Ave
Chicago, IL 60625-3661
Mailing address
2740 W Foster Ave
Ste 310
Chicago, IL 60625-3500
Phone (773) 878-8200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 238.000515 | IL | MD | Surgical Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490140800000",
"number": "1265980916",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2740 W FOSTER AVE",
"address_2": "STE 310",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606253500",
"telephone_number": "773-878-8200",
"fax_number": "773-293-8804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5145 N CALIFORNIA AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606253661",
"telephone_number": "773-878-8200",
"fax_number": "773-271-5090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARIS",
"first_name": "AHMAD",
"credential": "CSA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-09-12",
"last_updated": "2017-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "IL",
"license": "238.000515",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.