NPIMap

Organization Active NPI

Kidsmd PC

  • Pediatrics Physician
  • Willowbrook, IL
National Provider Identifier
1497341663
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
KIDSMD PC
Practice address
6827 Kingery Hwy
Willowbrook, IL 60527-5154
Phone
(917) 686-5676
NPI assigned
Dec 11, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

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

Authorized official

Name
Dr. Taaha Shakir, MDNPI 1811143290
Title
Owner
Phone
(917) 686-5676

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

6827 Kingery Hwy
Willowbrook, IL 60527-5154

Mailing address

37 Ridgefield LN
Willowbrook, IL 60527-5200
Phone (917) 686-5676

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1607644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607644800000",
    "number": "1497341663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 RIDGEFIELD LN",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605275200",
            "telephone_number": "917-686-5676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6827 KINGERY HWY",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605275154",
            "telephone_number": "917-686-5676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDSMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-11",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A",
        "authorized_official_last_name": "SHAKIR",
        "authorized_official_first_name": "TAAHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-686-5676",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willowbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; 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.