Individual provider Active NPI

Sargiss Khoshaba

  • Audiologist
  • Chicago, IL
National Provider Identifier
1457546129
Registry record updated Sep 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Practice address
1627 W Belmont Ave
Chicago, IL 60657-3017
Phone
(773) 477-1069
Fax
(773) 477-3462
NPI assigned
Sep 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X IL Primary
Community Based Hospice Care Agency 251G00000X IL

Addresses

Primary practice location

1627 W Belmont Ave
Chicago, IL 60657-3017

Mailing address

1627 W Belmont Ave
Chicago, IL 60657-3017
Phone (773) 477-1069

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
000002140ILMDCommunity Based Hospice Care Agency

Practice roles

OrganizationSpecialtyStatusNew patients
A-1 Hearing Aid Center, Inc. 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189036800000",
    "number": "1457546129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1627 W BELMONT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573017",
            "telephone_number": "773-477-1069",
            "fax_number": "773-477-3462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1627 W BELMONT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573017",
            "telephone_number": "773-477-1069",
            "fax_number": "773-477-3462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOSHABA",
        "first_name": "SARGISS",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-06",
        "last_updated": "2007-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "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 Sep 6, 2007; 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.