Organization Active NPI

Advanced Pulmonary Group LLC

  • Pulmonary Disease Physician
  • Burr Ridge, IL
National Provider Identifier
1588319735
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
ADVANCED PULMONARY GROUP LLC
Practice address
6081 Keller Dr
Burr Ridge, IL 60527-8124
Phone
(708) 539-6044
NPI assigned
Feb 16, 2022
Last updated
Aug 4, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

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

Authorized official

Name
Mohamed Zakkar, MDNPI 1285646828
Title
President
Phone
(708) 539-6044

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU
Critical Care Medicine (Internal Medicine) Physician 207RC0200X NU
Pulmonary Disease Physician 207RP1001X NU Primary
Sleep Medicine (Internal Medicine) Physician 207RS0012X NU

Addresses

Primary practice location

6081 Keller Dr
Burr Ridge, IL 60527-8124

Mailing address

6081 Keller Dr
Burr Ridge, IL 60527-8124
Phone (708) 539-6044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220427001358 IL Part B Supplier - Clinic/Group Practice 4587051248 Receives reassigned benefits from 1 practitioner
Practice locations: Burr Ridge, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1644969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659571200000",
    "number": "1588319735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6081 KELLER DR",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605278124",
            "telephone_number": "708-539-6044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6081 KELLER DR",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605278124",
            "telephone_number": "708-539-6044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PULMONARY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-16",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A",
        "authorized_official_last_name": "ZAKKAR",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-539-6044",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burr Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2022; 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.

Verify at the official NPI Registry.