Individual provider Active NPI

Mohamed M Zakkar, M.D.

  • Pulmonary Disease Physician
  • Chicago Ridge, IL
National Provider Identifier
1285646828
Registry record updated Jun 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
35-07-5771-Z Issued in OH
Practice address
10604 Southwest Highway
Suite 107
Chicago Ridge, IL 60415-2717
Phone
(708) 371-8006
Fax
(708) 389-6630
NPI assigned
Aug 12, 2006
Last updated
Jun 8, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 35-07-5771-Z OH Primary

Addresses

Primary practice location

10604 Southwest Highway
Suite 107
Chicago Ridge, IL 60415-2717

Mailing address

10604 Southwest Highway
Suite 107
Chicago Ridge, IL 60415-2717
Phone (708) 371-8006

Other identifiers 1

IdentifierTypeStateIssuer
2119755MedicaidOH

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
I20100315000854 IL Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 6507842713 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6081 Keller Dr
Burr Ridge, IL 60527-8124
Phone (630) 454-0257

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Jan 1, 2022 Accepting new patients
Midwest Pulmonary Critical Care & Sleep Consultants LLC Pulmonary Disease CurrentSince May 1, 2018 Accepting new patients
Advanced Pulmonary Group LLC Pulmonary Disease CurrentSince Mar 15, 2022 Accepting new patients
Central Dupage Physician Group CurrentSince Jan 1, 2022 Accepting new patients
Dayton Lung and Sleep Medicine Inc Pulmonary Disease Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

2875 W 19th St
Chicago, IL 60623
Phone (773) 484-4300

29777 Network Pl
Chicago, IL 60673

10604 Southwest Hwy
Ste 107
Chicago Ridge, IL 60415
Phone (708) 371-8006

1890 Silver Cross Blvd
Ste 345
New Lenox, IL 60451
Phone (815) 462-9300

4440 W 95th St
Oak Lawn, IL 60453
Phone (708) 346-5520

4440 W 95th St
Ste Aip
Oak Lawn, IL 60453
Phone (708) 684-8000

12820 S Ridgeland Ave
Ste B
Palos Heights, IL 60463
Phone (708) 371-6009

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Interoperability endpoints

  • Direct secure messaging: mzakkarmd237172@uchospital.direct-ci.com

Organizations & group practices 5

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 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": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528416000000",
    "number": "1285646828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10604 SOUTHWEST HIGHWAY",
            "address_2": "SUITE 107",
            "city": "CHICAGO RIDGE",
            "state": "IL",
            "postal_code": "604152717",
            "telephone_number": "708-371-8006",
            "fax_number": "708-389-6630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10604 SOUTHWEST HIGHWAY",
            "address_2": "SUITE 107",
            "city": "CHICAGO RIDGE",
            "state": "IL",
            "postal_code": "604152717",
            "telephone_number": "708-371-8006",
            "fax_number": "708-389-6630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAKKAR",
        "first_name": "MOHAMED",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2018-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OH",
            "license": "35-07-5771-Z",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2119755",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago Ridge, IL

Sources for this page

Verify at the official NPI Registry.