Individual provider Active NPI

Rasha William Atallah, M.D.

  • Family Medicine Physician
  • Burbank, IL
National Provider Identifier
1750768685
Registry record updated Apr 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036144531 Issued in IL
Practice address
4901 W 79TH St Ste 10
Burbank, IL 60459-1554
Phone
(708) 422-7100
NPI assigned
Apr 29, 2015
Last updated
Apr 4, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036144531 IL Primary
Student in an Organized Health Care Education/Training Program 390200000X 125067774 IL

Addresses

Primary practice location

4901 W 79TH St Ste 10
Burbank, IL 60459-1554

Mailing address

4901 W 79TH St Ste 10
Burbank, IL 60459-1554
Phone (708) 422-7100

Other practice location 1

1431 N Western Ave Ste 406
Chicago, IL 60622-1774
Phone (312) 633-5841

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180618001618 IL Practitioner - Family Practice 6204135270 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Little Company of Mary Affiliated Services Inc Current Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Little Company of Mary Affiliated Services Inc CurrentSince Jun 21, 2018 Accepting new patients
Osf Multi-Specialty Group CurrentSince Nov 30, 2019 Accepting new patients
Ottawa Regional Medical Center Inc. Family Medicine Past Accepting new patients
Saint Anthony Medical Center Family Medicine Past Accepting new patients
Cardinal Medical Group, LTD. Family Medicine Past Accepting new patients

Locations

4901 W 79th St
Burbank, IL 60459
Phone (708) 425-9321

4901 W 79th St
Ste 10
Burbank, IL 60459
Phone (708) 422-7100

7945 S Harlem Ave
Burbank, IL 60459
Phone (708) 907-4355

2800 W 87th St
Chicago, IL 60652
Phone (312) 423-4200

5660 W 95th St
Ste 1
Oak Lawn, IL 60453
Phone (708) 499-2273

12450 S Harlem Ave
Palos Heights, IL 60463
Phone (708) 448-1207

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554336000000",
    "number": "1750768685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4901 W 79TH ST STE 10",
            "city": "BURBANK",
            "state": "IL",
            "postal_code": "604591554",
            "telephone_number": "708-422-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 W 79TH ST STE 10",
            "city": "BURBANK",
            "state": "IL",
            "postal_code": "604591554",
            "telephone_number": "708-422-7100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1431 N Western Ave Ste 406",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606221774",
            "country_code": "US",
            "telephone_number": "312-633-5841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ATALLAH",
        "first_name": "RASHA",
        "middle_name": "WILLIAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-29",
        "last_updated": "2019-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036144531",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "125067774",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, IL

Sources for this page

Verify at the official NPI Registry.