Shadi Jibawi, MD

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

036146320 Issued in IL

Practice address

20201 Crawford Ave
Olympia Fields, IL 60461-1010

Phone

(708) 679-2160

Fax

(708) 679-2161

NPI assigned

Jun 12, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI, IL2 enrollments

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 2

Specialty

HospitalistAlso: Internal Medicine

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sound Physicians of Illinois LLCGroup PAC ID 1557533734, 193 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Franciscan Health Olympia & Chicago Heights Hospital, Olympia Fields, IL, CCN 140172

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sjibawi401201@direct.franciscanalliance.org

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.

• Sound Physicians of Illinois, LLC

  • Hospitalist Physician
  • Bridgeton, MO
  • NPI 1043598865

  IL, Internal Medicine

  Medicare reassignment Care Compare group NPD
• Bronson Lakeview Hospital

  • Internal Medicine Physician
  • Paw Paw, MI
  • NPI 1235131137
  Medicare reassignment NPD
• Bronson Methodist Hospital

  • Hospitalist Physician
  • Kalamazoo, MI
  • NPI 1417961137
  Medicare reassignment NPD
• Bronson Lakeview Hospital

  • Rural Health Clinic/Center
  • South Haven, MI
  • NPI 1801538871
  NPD
• Patholgy Services of Kalamazoo, PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Kalamazoo, MI
  • NPI 1548243595
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Franciscan Health Olympia Fields

  • General Acute Care Hospital
  • Olympia Fields, IL
  • NPI 1588771919
  Care Compare affiliation

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

{
    "created_epoch": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1568622686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6530 BELGIAN AVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490098985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20201 CRAWFORD AVE",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611010",
            "telephone_number": "708-679-2160",
            "fax_number": "708-679-2161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 John St",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490075341",
            "country_code": "US",
            "telephone_number": "269-341-8481",
            "fax_number": "269-341-7781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIBAWI",
        "first_name": "SHADI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-12",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "03614632",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301092393",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036146320",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "03614632",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301092393",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036146320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1568622686",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM - BRONSON",
            "identifier": "1417961137",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sjibawi401201@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "20201 Crawford Ave",
            "city": "Olympia Fields",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604611010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Faiza Javed, MD
• Rabia Jawed, DO
• Filip Jelenak
• Dawyn Marie Jenkins
• Erin Jennings Lugowski, CRNA
• Michelle Jiles
• Shalon A Johnson-Eggleston, MA
• Angela Johnson
• Carol A Jones
• Clarissa Jones, ACNP

• Hospitalist Physician in Olympia Fields, IL
• Providers in Olympia Fields, IL by specialty
• Hospitalist Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.