Active NPI
Manal Alotaibi, MBBS
- Nephrology Physician
- Chicago, IL
National Provider Identifier
1508399775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 036152636
- Practice address
- 251 E Huron St
Chicago, IL 60611-2908 - Phone
- (312) 926-2000
- NPI assigned
- Apr 5, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | NA | IL | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Nephrology Physician | 207RN0300X | 036152636 | IL | Primary |
Addresses
Primary practice location
251 E Huron St
Chicago, IL 60611-2908
Mailing address
710 N Fairbanks CT
Chicago, IL 60611-3013
Phone (312) 926-4188
Other practice location 1
22 S Greene St Rm N3E09
Baltimore, MD 21201-1544
Phone (410) 328-6110
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036152636 | IL | MD | Nephrology Physician |
Interoperability endpoints
- malotaibi979966@direct.hopkinsmedicine.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593302400000",
"number": "1508399775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "710 N FAIRBANKS CT",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606113013",
"telephone_number": "312-926-4188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "251 E HURON ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112908",
"telephone_number": "312-926-2000"
}
],
"practiceLocations": [
{
"address_1": "22 S Greene St Rm N3E09",
"address_purpose": "LOCATION",
"city": "Baltimore",
"state": "MD",
"postal_code": "212011544",
"country_code": "US",
"telephone_number": "410-328-6110",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ALOTAIBI",
"first_name": "MANAL",
"credential": "MBBS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-05",
"last_updated": "2020-06-28",
"certification_date": "2020-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "IL",
"license": "NA",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "IL",
"license": "036152636",
"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 Jun 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.