Active NPI
Elder Care Physicians LLC
- Internal Medicine Physician
- Lombard, IL
National Provider Identifier
1558068700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- ELDER CARE PHYSICIANS LLC
- Practice address
- 1S072 Luther Ave
Lombard, IL 60148-4164 - Phone
- (872) 888-2444
- NPI assigned
- Feb 8, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Shahaab Uddin, MD
- Title
- Owner
- Phone
- (872) 888-2444
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
1S072 Luther Ave
Lombard, IL 60148-4164
Mailing address
384 E 17TH PL
Lombard, IL 60148-4926
Phone (872) 888-2444
Other names 1
- ELDER CARE PHYSICIANS LLC
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, IN
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230405002081 | IL | Part B Supplier - Clinic/Group Practice | 6204201254 |
Receives reassigned benefits from 6 practitioners Practice locations: Lombard, IL |
| O20230831003835 | IN | Part B Supplier - Clinic/Group Practice | 6204201254 |
Receives reassigned benefits from 1 practitioner Practice locations: South Bend, IN |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- New Albany, IN
- NPI 1669784872
IL, IN, Internal Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675814400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1676160000000",
"number": "1558068700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "384 E 17TH PL",
"city": "LOMBARD",
"state": "IL",
"postal_code": "601484926",
"telephone_number": "872-888-2444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1S072 LUTHER AVE",
"city": "LOMBARD",
"state": "IL",
"postal_code": "601484164",
"telephone_number": "872-888-2444"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ELDER CARE PHYSICIANS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-02-08",
"last_updated": "2023-02-12",
"certification_date": "2023-02-12",
"status": "A",
"authorized_official_last_name": "UDDIN",
"authorized_official_first_name": "SHAHAAB",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "872-888-2444",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "ELDER CARE PHYSICIANS LLC",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Lombard, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.