Organization Active NPI

Nader Beshay MD SC

  • Internal Medicine Physician
  • Hazel Crest, IL
National Provider Identifier
1376694299
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036084972 Issued in IL
Legal business name
NADER BESHAY MD SC
Practice address
3330 W 177TH St Ste 3H
Hazel Crest, IL 60429-2186
Phone
(708) 922-1866
Fax
(708) 922-3803
NPI assigned
Jan 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Authorized official

Name
Dr. Nader M Beshay, MD
Title
Physician
Phone
(708) 922-1866

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 036084972 IL Primary

Addresses

Primary practice location

3330 W 177TH St Ste 3H
Hazel Crest, IL 60429-2186

Mailing address

3330 W 177TH St Ste 3H
Hazel Crest, IL 60429-2186
Phone (708) 922-1866

Other identifiers 2

IdentifierTypeStateIssuer
14D1041814OtherILCLIA WAIVER
036084972MedicaidIL

National Provider Directory

National Provider Directory

Locations

3330 W 177th St
Ste 3H
Hazel Crest, IL 60429
Phone (708) 473-7084

17680 Kedzie Ave
Ste 204
Hazel Crest, IL 60429
Phone (708) 922-1866

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687305600000",
    "number": "1376694299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 W 177TH ST STE 3H",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292186",
            "telephone_number": "708-922-1866",
            "fax_number": "708-922-3803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 W 177TH ST STE 3H",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292186",
            "telephone_number": "708-922-1866",
            "fax_number": "708-922-3803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NADER BESHAY MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A",
        "authorized_official_last_name": "BESHAY",
        "authorized_official_first_name": "NADER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "708-922-1866",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036084972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA WAIVER",
            "identifier": "14D1041814",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036084972",
            "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 Jun 21, 2023; 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.