Individual provider Active NPI

Ahmad A. Shaher, M.D.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1376656975
Registry record updated Mar 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-114223 Issued in IL
Practice address
2906 W Peterson Ave
Chicago, IL 60659-3813
Phone
(773) 754-0088
NPI assigned
Aug 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-114223 IL Primary

Addresses

Primary practice location

2906 W Peterson Ave
Chicago, IL 60659-3813

Mailing address

1027 Harlem Ave
Forest Park, IL 60130-2336
Phone (708) 299-3524

Other identifiers 1

IdentifierTypeStateIssuer
036-114223OtherILLICENSE

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
I20071012000338 IL Practitioner - Family Practice 6709972334 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Rose Healthcare Management LLCGroup PAC ID 4981010048, 18 clinicians
Great Lakes Emergency Physicians Medical Group SCGroup PAC ID 8527493105, 15 clinicians

Practice addresses (Care Compare)

45 W 111TH St
Chicago, IL 60628-4200
Phone (773) 995-3000

7531 S Stony Island Ave
Chicago, IL 60649-3954
Phone (773) 947-7500

Hospital & facility affiliations

  • Roseland Community Hospital Hospital, Chicago, IL, CCN 140068
  • Jackson Park Hospital Hospital, Chicago, IL, CCN 140177

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-114223ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Park Hospital Foundation Current Accepting new patients
Great Lakes Emergency Physicians Medical Group SC CurrentSince Dec 2, 2019 Accepting new patients
New Rose Healthcare Management LLC CurrentSince Feb 23, 2021 Accepting new patients
Emergency Medical Specialists, II, S.C. Past Accepting new patients
Indiana University Health Starke Hospital LLC Past Accepting new patients

Locations

45 W 111th St
Chicago, IL 60628
Phone (773) 995-3000

7531 S Stony Island Ave
Chicago, IL 60649
Phone (773) 947-7310

Interoperability endpoints

  • Direct secure messaging: ahmadshaher@jph.medalliesdirect.net

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 and National Provider Directory roles.

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395619200000",
    "number": "1376656975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 HARLEM AVE",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601302336",
            "telephone_number": "708-299-3524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2906 W PETERSON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606593813",
            "telephone_number": "773-754-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHER",
        "first_name": "AHMAD",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2014-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-114223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "036-114223",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.