Organization Active NPI

SFZ Corporation

  • Internal Medicine Physician
  • Hazel Crest, IL
National Provider Identifier
1356530547
Registry record updated May 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036085180 Issued in IL
Legal business name
SFZ CORPORATION
Practice address
3330 W 177TH St
Suite 3D
Hazel Crest, IL 60429-2184
Phone
(708) 957-4278
NPI assigned
Oct 24, 2007
Last updated
May 4, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2010

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

Authorized official

Name
Dr. Shahla Zaidi, M.D.NPI 1528013026
Title
Owner
Phone
(708) 349-0055

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 036085180 IL Primary

Addresses

Primary practice location

3330 W 177TH St
Suite 3D
Hazel Crest, IL 60429-2184

Mailing address

10660 W 143Rd St
Suite B
Orland Park, IL 60462-1982
Phone (708) 349-0055

Other identifiers 3

IdentifierTypeStateIssuer
0021623323OtherILBLUE CROSS BLUE SHIELD
036085180MedicaidIL
0801779OtherILPALMETTO RR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051109000330 IL Part B Supplier - Clinic/Group Practice 7214955160 Receives reassigned benefits from 1 practitioner
Practice locations: Hazel Crest, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272931200000",
    "number": "1356530547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10660 W 143RD ST",
            "address_2": "SUITE B",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604621982",
            "telephone_number": "708-349-0055",
            "fax_number": "708-460-8031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 W 177TH ST",
            "address_2": "SUITE 3D",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292184",
            "telephone_number": "708-957-4278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SFZ CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-24",
        "last_updated": "2010-05-04",
        "status": "A",
        "authorized_official_last_name": "ZAIDI",
        "authorized_official_first_name": "SHAHLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-349-0055",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036085180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0021623323",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036085180",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO RR MEDICARE",
            "identifier": "0801779",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazel Crest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2010; 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.