Individual provider Active NPI

Tarek El-Shikh, PT, DPT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1386650885
Registry record updated Apr 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.006954 Issued in IL
Practice address
5764 S Archer Ave
Chicago, IL 60638-1643
Phone
(773) 284-0888
Fax
(773) 284-0880
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070.006954 IL Primary
Specialist 174400000X 05003251A IN
Specialist 174400000X 070006954 IL

Addresses

Primary practice location

5764 S Archer Ave
Chicago, IL 60638-1643

Mailing address

5764 S Archer Ave
Chicago, IL 60638-1643
Phone (773) 284-0888

Other identifiers 6

IdentifierTypeStateIssuer
201070AOtherINMEDICARE PTAN
650026089OtherINMEDICARE RAIL ROAD
2157528OtherFIRST HEALTH
000000277684OtherINBC/BS ANTHEM
90001118OtherILBC/BS OF ILLINOIS
IL 5301001OtherILMEDICARE PTAN

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

State licenses

LicenseStateTypeSpecialty
070006954ILMDSpecialist
05003251AINMDSpecialist
070.006954ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397692800000",
    "number": "1386650885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5764 S ARCHER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606381643",
            "telephone_number": "773-284-0888",
            "fax_number": "773-284-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5764 S ARCHER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606381643",
            "telephone_number": "773-284-0888",
            "fax_number": "773-284-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EL-SHIKH",
        "first_name": "TAREK",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2014-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.006954",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IN",
            "license": "05003251A",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "070006954",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "201070A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAIL ROAD",
            "identifier": "650026089",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "2157528",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS  ANTHEM",
            "identifier": "000000277684",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF ILLINOIS",
            "identifier": "90001118",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "IL 5301001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2014; 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.