Organization Active NPI

Yazen Joudeh MD LTD

  • Internal Medicine Physician
  • Orland Park, IL
National Provider Identifier
1669734802
Registry record updated Aug 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
YAZEN JOUDEH MD LTD
Practice address
16501 106TH CT
Orland Park, IL 60467-4522
Phone
(708) 904-4979
Fax
(708) 407-9006
NPI assigned
Jun 13, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2025

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

Authorized official

Name
Dr. Yazen Joudeh, M.D.NPI 1134301773
Title
Physician
Phone
(708) 904-4979

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)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

16501 106TH CT
Orland Park, IL 60467-4522

Mailing address

16501 106TH CT
Orland Park, IL 60467-4522
Phone (708) 904-4979

Other identifiers 1

IdentifierTypeStateIssuer
036124274MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121029000705 IL Part B Supplier - Clinic/Group Practice 3274783279 Receives reassigned benefits from 3 practitioners
Practice locations: Orland Park, IL

National Provider Directory

National Provider Directory

Locations

9830 Ridgeland Ave
Ste 101
Chicago Ridge, IL 60415
Phone (708) 423-3800

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754697600000",
    "number": "1669734802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16501 106TH CT",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604674522",
            "telephone_number": "708-904-4979",
            "fax_number": "708-407-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16501 106TH CT",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604674522",
            "telephone_number": "708-904-4979",
            "fax_number": "708-407-9006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YAZEN JOUDEH MD LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-13",
        "last_updated": "2025-08-09",
        "certification_date": "2025-08-09",
        "status": "A",
        "authorized_official_last_name": "JOUDEH",
        "authorized_official_first_name": "YAZEN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "708-904-4979",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036124274",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2025; 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.