Individual provider Active NPI

Abdul Qadir Karim

  • Dentist
  • Aurora, IL
National Provider Identifier
1407585953
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019033602 Issued in IL
Practice address
1480 N Orchard Rd Ste 104
Aurora, IL 60506-7940
Phone
(630) 733-1111
NPI assigned
Jun 9, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019033602 IL Primary

Addresses

Primary practice location

1480 N Orchard Rd Ste 104
Aurora, IL 60506-7940

Mailing address

422 Grape Vine TRL
Oswego, IL 60543-6037
Phone (630) 864-1438

Other identifiers 1

IdentifierTypeStateIssuer
1366678500MedicaidIL

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
019033602ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1654732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1407585953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 GRAPE VINE TRL",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605436037",
            "telephone_number": "630-864-1438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1480 N ORCHARD RD STE 104",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605067940",
            "telephone_number": "630-733-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARIM",
        "first_name": "ABDUL",
        "middle_name": "QADIR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-09",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019033602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366678500",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; 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.