Individual provider Active NPI

Reem Shafi, D.D.S

  • General Practice Dentistry
  • Aurora, IL
National Provider Identifier
1578624698
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Practice address
1137 N. Eola Rd
Suite 109
Aurora, IL 60504
Phone
(630) 898-2688
Fax
(630) 898-0017
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X IL Primary

Addresses

Primary practice location

1137 N. Eola Rd
Suite 109
Aurora, IL 60504

Mailing address

1137 N. Eola Rd
Suite 109
Aurora, IL 60504
Phone (630) 898-2688

Other identifiers 1

IdentifierTypeStateIssuer
1004872MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
019024809ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1578624698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1137 N. EOLA RD",
            "address_2": "SUITE 109",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "60504",
            "telephone_number": "630-898-2688",
            "fax_number": "630-898-0017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1137 N. EOLA RD",
            "address_2": "SUITE 109",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "60504",
            "telephone_number": "630-898-2688",
            "fax_number": "630-898-0017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFI",
        "first_name": "REEM",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1004872",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.