Optimum Kidney Care SC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

OPTIMUM KIDNEY CARE SC

Practice address

331 W Surf St Ste 703
Chicago, IL 60657-7227

Phone

(773) 525-4701

Fax

(773) 326-3539

NPI assigned

May 30, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Mohamed Medhat SalemNPI 1538139316

Title

President

Phone

(773) 525-4701

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mohamed Medhat Salem, M.D.

  • Nephrology Physician
  • Chicago, IL
  • NPI 1538139316
  Medicare reassignment NPD Authorized official
• Izabella Gurau, MD

  • Nephrology Physician
  • Chicago, IL
  • NPI 1821034885
  NPD (past)
• Rajani Kosuri, M.D.

  • Nephrology Physician
  • Melrose Park, IL
  • NPI 1346455185
  NPD (past)
• Thodur M Ranganathan, M.D.

  • Psychiatry Physician
  • Chicago, IL
  • NPI 1841269727
  NPD (past)
• Osvaldo Wagener, M.D.

  • Nephrology Physician
  • Melrose Park, IL
  • NPI 1770563009
  NPD (past)

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586390400000",
    "number": "1306893797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 W SURF ST STE 703",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606577227",
            "telephone_number": "773-525-4701",
            "fax_number": "773-326-3539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 W SURF ST STE 703",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606577227",
            "telephone_number": "773-525-4701",
            "fax_number": "773-326-3539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM KIDNEY CARE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-30",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A",
        "authorized_official_last_name": "SALEM",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_middle_name": "MEDHAT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-525-4701",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "01636011",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVOCATE HLTH PARTNERS ID",
            "identifier": "151011",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE4201",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Optimal Performance & Reconditioning
• Optimize Nutrition LLC
• Optimized Clinical Services
• Optimum Dental Center, PC
• Optimum Joy, P.C.
• Optimum Professionals Home Health Care Inc.
• Optimum Sight Inc.
• Optimum Vision Inc
• Options Funtional Health SC
• Options Medical LLC

• Nephrology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Nephrology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.