Individual provider Active NPI

Salim Joseph Dawalibi, MD

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1447413547
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-121343 Issued in IL
Practice address
500 E 51St St
Chicago, IL 60615-2400
Phone
(312) 572-2643
NPI assigned
Jul 8, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-121343 IL Primary

Addresses

Primary practice location

500 E 51St St
Chicago, IL 60615-2400

Mailing address

3148 Everglade Ave
Woodridge, IL 60517-3315
Phone (708) 268-1860

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sdawalibi@direct.ccprovider.org Direct Cook County

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250321002297 IL Order and Referring Only - Family PracticePractitioner - Family Practice 6305912411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-121343ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Suburban Emergency Physicians Group, SC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sdawalibi@direct.ccprovider.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1447413547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3148 EVERGLADE AVE",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605173315",
            "telephone_number": "708-268-1860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E 51ST ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606152400",
            "telephone_number": "312-572-2643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWALIBI",
        "first_name": "SALIM",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-08",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-121343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sdawalibi@direct.ccprovider.org",
            "affiliation": "Y",
            "affiliationName": "Cook County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1969 W. Ogden Ave.",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.