NPIMap

Individual provider Active NPI

Azzam M Alkhudari, MD

  • Pain Medicine (Anesthesiology) Physician
  • Oak Lawn, IL
National Provider Identifier
1285706754
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
036-113149 Issued in IL
Practice address
5669 W 95TH St Ste 3a
Oak Lawn, IL 60453-2382
Phone
(708) 634-2627
Fax
(630) 246-3166
NPI assigned
Nov 14, 2006
Last updated
Nov 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036-113149 IL
Pain Medicine (Anesthesiology) Physician 207LP2900X 036-113149 IL Primary

Addresses

Primary practice location

5669 W 95TH St Ste 3a
Oak Lawn, IL 60453-2382

Mailing address

8S180 S Vine St
Burr Ridge, IL 60527-5542
Phone (630) 590-5809

Other practice location 1

8S180 S Vine St
Burr Ridge, IL 60527-5542
Phone (630) 590-5809

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aalkhudari@direct.ccprovider.org Direct Cook County

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120612000510 IL Practitioner - Pain ManagementPractitioner - Anesthesiology 1951405851 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cook CountyGroup PAC ID 2860398088, 770 clinicians

Practice addresses (Care Compare)

1901 W Harrison St
Chicago, IL 60612-3714
Phone (312) 633-7292

500 E 51St St
Chicago, IL 60615-2494
Phone (312) 572-2000

5669 W 95TH St
Suite 3
Oak Lawn, IL 60453-6501
Phone (708) 634-2627

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002755NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Pain Care Center Inc Pain Medicine CurrentSince Apr 6, 2014 Accepting new patients
Cook County Current Accepting new patients
Cook County Anesthesiology CurrentSince Apr 17, 2012 Accepting new patients
Cook County CurrentSince Apr 17, 2012 Accepting new patients
Dansville Anesthesia & Pain Treatment, PLLC Anesthesiology Past Accepting new patients
John T Goodsell DO PC Gregory Linderer MD LTD Anesthesiology PastSince Nov 18, 2009 Accepting new patients

Locations

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

1969 W Ogden Ave
Chicago, IL 60612
Phone (312) 864-3600

25706 Network Pl
Chicago, IL 60673

4909 W Division St
Chicago, IL 60651
Phone (773) 854-8000

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

5669 W 95th St
Oak Lawn, IL 60453
Phone (708) 422-4180

5669 W 95th St
Ste 3
Oak Lawn, IL 60453
Phone (630) 590-5809

5669 W 95th St
Ste 3A
Oak Lawn, IL 60453
Phone (708) 634-2627

Interoperability endpoints

  • Direct secure messaging: aalkhudari@direct.ccprovider.org

Organizations & group practices 6

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 29

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1285706754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8S180 S VINE ST",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605275542",
            "telephone_number": "630-590-5809",
            "fax_number": "630-246-3166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5669 W 95TH ST STE 3A",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532382",
            "telephone_number": "708-634-2627",
            "fax_number": "630-246-3166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8S180 S Vine St",
            "address_purpose": "LOCATION",
            "city": "Burr Ridge",
            "state": "IL",
            "postal_code": "605275542",
            "country_code": "US",
            "telephone_number": "630-590-5809",
            "fax_number": "630-246-3166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALKHUDARI",
        "first_name": "AZZAM",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2024-11-11",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036-113149",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "036-113149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aalkhudari@direct.ccprovider.org",
            "affiliation": "Y",
            "affiliationName": "Cook County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1969 W. Ogden Ave.",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

Verify at the official NPI Registry.