Individual provider Active NPI

Sabiha Thaseen, M.D.

  • Internal Medicine Physician
  • Cicero, IL
National Provider Identifier
1508900168
Registry record updated Jun 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-092253 Issued in IL
Practice address
5535 W Cermak Rd Ste a
Cicero, IL 60804-2218
Phone
(708) 780-7705
Fax
(708) 780-7795
NPI assigned
Feb 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 036-092253 IL Primary

Addresses

Primary practice location

5535 W Cermak Rd Ste a
Cicero, IL 60804-2218

Mailing address

5535 W Cermak Rd Ste a
Cicero, IL 60804-2218
Phone (708) 780-7705

Other identifiers 2

IdentifierTypeStateIssuer
01622612OtherILBLUE CROSS BLUE SHIELD
036092253MedicaidIL

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
I20040720000586 IL Practitioner - Internal Medicine 3173502481 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5535 W Cermak Rd
Suite a
Cicero, IL 60804-2218
Phone (708) 780-7705

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-092253ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sana & Saba Medical Center LTD. Single Specialty CurrentSince Apr 12, 2004 Accepting new patients

Locations

5535 W Cermak Rd
#A
Cicero, IL 60804

5535 W Cermak Rd
Ste A
Cicero, IL 60804
Phone (708) 780-7705

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": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496880000000",
    "number": "1508900168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5535 W CERMAK RD STE A",
            "city": "CICERO",
            "state": "IL",
            "postal_code": "608042218",
            "telephone_number": "708-780-7705",
            "fax_number": "708-780-7795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5535 W CERMAK RD STE A",
            "city": "CICERO",
            "state": "IL",
            "postal_code": "608042218",
            "telephone_number": "708-780-7705",
            "fax_number": "708-780-7795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THASEEN",
        "first_name": "SABIHA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2017-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-092253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01622612",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036092253",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cicero, IL

Sources for this page

Verify at the official NPI Registry.