Individual provider Active NPI

Shahida Zia Rehman

  • Clinical Medical Laboratory
  • Chicago, IL
National Provider Identifier
1396289914
Registry record updated Dec 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
14D2118590 Issued in IL
Practice address
6449 S Pulaski Rd
Suite 108
Chicago, IL 60629-5148
Phone
(773) 306-1259
Fax
(773) 306-1259
NPI assigned
Dec 16, 2016
Last updated
Dec 16, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 14D2118590 IL Primary

Addresses

Primary practice location

6449 S Pulaski Rd
Suite 108
Chicago, IL 60629-5148

Mailing address

6449 S Pulaski Rd
Suite 108
Chicago, IL 60629-5148
Phone (773) 306-1259

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
14D2118590ILMDClinical Medical Laboratory

Practice roles

OrganizationSpecialtyStatusNew patients
Abc Labs Clinical Medical Laboratory Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1481846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481846400000",
    "number": "1396289914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6449 S PULASKI RD",
            "address_2": "SUITE 108",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606295148",
            "telephone_number": "773-306-1259",
            "fax_number": "773-306-1259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6449 S PULASKI RD",
            "address_2": "SUITE 108",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606295148",
            "telephone_number": "773-306-1259",
            "fax_number": "773-306-1259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REHMAN",
        "first_name": "SHAHIDA",
        "middle_name": "ZIA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-16",
        "last_updated": "2016-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IL",
            "license": "14D2118590",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 16, 2016; 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.