Organization Active NPI

Safeguard Covid LLC

  • Clinic/Center
  • Champaign, IL
National Provider Identifier
1619628310
Registry record updated Jan 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SAFEGUARD COVID LLC
Practice address
1804 S Neil St
Champaign, IL 61820-7216
Phone
(217) 778-7327
NPI assigned
Jan 13, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2022

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

Authorized official

Name
Samar Abdel-Jaber
Title
Ceo
Phone
(217) 778-7327

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1804 S Neil St
Champaign, IL 61820-7216

Mailing address

1804 S Neil St
Champaign, IL 61820-7216
Phone (217) 778-7327

National Provider Directory

National Provider Directory

Locations

1804 S Neil St
Champaign, IL 61820
Phone (217) 778-7327

NPI Registry JSON

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

{
    "created_epoch": "1642032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642032000000",
    "number": "1619628310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 S NEIL ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618207216",
            "telephone_number": "217-778-7327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 S NEIL ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618207216",
            "telephone_number": "217-778-7327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFEGUARD COVID LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-13",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A",
        "authorized_official_last_name": "ABDEL-JABER",
        "authorized_official_first_name": "SAMAR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "217-778-7327"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2022; 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.