Active NPI
Tarek El-Shikh, PT, DPT
- Physical Therapist
- Chicago, IL
National Provider Identifier
1386650885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070.006954
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201070A | Other | IN | MEDICARE PTAN |
| 650026089 | Other | IN | MEDICARE RAIL ROAD |
| 2157528 | Other | FIRST HEALTH | |
| 000000277684 | Other | IN | BC/BS ANTHEM |
| 90001118 | Other | IL | BC/BS OF ILLINOIS |
| IL 5301001 | Other | IL | MEDICARE 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
| License | State | Type | Specialty |
|---|---|---|---|
| 070006954 | IL | MD | Specialist |
| 05003251A | IN | MD | Specialist |
| 070.006954 | IL | MD | Physical 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.