Organization Active NPI

Osama K. Atieh MDSC

  • Internal Medicine Physician
  • Palos Heights, IL
National Provider Identifier
1679631444
Registry record updated Feb 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036086966 Issued in IL
Legal business name
OSAMA K. ATIEH MDSC
Practice address
12050 S Harlem Ave
Unit B
Palos Heights, IL 60463-1470
Phone
(708) 361-5788
Fax
(708) 361-5508
NPI assigned
Dec 5, 2006
Last updated
Feb 1, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2010

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

Authorized official

Name
Dr. Osama Khairy Atieh, M.D.NPI 1083821565
Title
President
Phone
(708) 361-5788

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 036086966 IL Primary

Addresses

Primary practice location

12050 S Harlem Ave
Unit B
Palos Heights, IL 60463-1470

Mailing address

12050 S Harlem Ave
Unit B
Palos Heights, IL 60463-1470
Phone (708) 361-5788

Other identifiers 1

IdentifierTypeStateIssuer
036086966MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050603000119 IL Part B Supplier - Clinic/Group Practice 4486697257 Receives reassigned benefits from 1 practitioner
Practice locations: Palos Heights, IL

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JIICCA

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": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264982400000",
    "number": "1679631444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12050 S HARLEM AVE",
            "address_2": "UNIT B",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631470",
            "telephone_number": "708-361-5788",
            "fax_number": "708-361-5508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12050 S HARLEM AVE",
            "address_2": "UNIT B",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631470",
            "telephone_number": "708-361-5788",
            "fax_number": "708-361-5508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSAMA K. ATIEH MDSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2010-02-01",
        "status": "A",
        "authorized_official_last_name": "ATIEH",
        "authorized_official_first_name": "OSAMA",
        "authorized_official_middle_name": "KHAIRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-361-5788",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036086966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036086966",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2010; 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.