S&S Dynamic LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

S&S DYNAMIC LLC

Practice address

174 Holly St
Bolingbrook, IL 60490-2107

Phone

(847) 650-0728

NPI assigned

May 9, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Shaheera Khan, DPMNPI 1861059834

Title

Podiatrist

Phone

(847) 650-0728

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

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

• Shaheera Fatima Khan, DPM

  • Foot & Ankle Surgery Podiatrist
  • Chicago, IL
  • NPI 1861059834
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1683590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693353600000",
    "number": "1740970284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 HOLLY ST",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604902107",
            "telephone_number": "847-650-0728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 HOLLY ST",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604902107",
            "telephone_number": "847-650-0728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S&S DYNAMIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-09",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "SHAHEERA",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "847-650-0728",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sujaya P Rupani, MD
• Russell J Bak DDS PC
• Catherine Elizabeth Russell, PT, DPT
• Casey Ryan
• Sarah Ryan, BCBA
• Vibha Sabharwal, M.D.
• Sabs Corporation
• Michele Karen Sackheim, DDS MSD
• Joseph Saclolo
• Moazzam Saeed, M.D.

• Foot & Ankle Surgery Podiatrist in Bolingbrook, IL
• Providers in Bolingbrook, IL by specialty
• Foot & Ankle Surgery Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; 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.