Individual provider Active NPI

Abdul Amine, MD

  • Neurological Surgery Physician
  • Oak Lawn, IL
National Provider Identifier
1356415350
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Practice address
6815 West 95TH Street
Oak Lawn, IL 60453-7000
Phone
(708) 430-3350
Fax
(708) 430-3551
NPI assigned
Nov 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X IL Primary

Addresses

Primary practice location

6815 West 95TH Street
Oak Lawn, IL 60453-7000

Mailing address

6815 West 95TH Street
Oak Lawn, IL 60453-7000
Phone (708) 430-3350

Other identifiers 1

IdentifierTypeStateIssuer
21607606OtherBC BS

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036046811ILMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chicago Ridge Radiology SC PastSince Dec 1, 2000 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356415350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6815 WEST 95TH STREET",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604537000",
            "telephone_number": "708-430-3350",
            "fax_number": "708-430-3551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6815 WEST 95TH STREET",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604537000",
            "telephone_number": "708-430-3350",
            "fax_number": "708-430-3551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMINE",
        "first_name": "ABDUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "21607606",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.