NPIMap

Individual provider Active NPI

Salem Jad Makdah, M.D.

  • Internal Medicine Physician
  • Orland Park, IL
National Provider Identifier
1760430557
Registry record updated Jan 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036075762 Issued in IL
Practice address
15300 West Ave
Orland Park, IL 60462-4600
Phone
(708) 923-7874
Fax
(708) 923-7876
NPI assigned
May 4, 2006
Reactivated
Sep 19, 2018
Last updated
Jan 3, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036075762 IL Primary

Addresses

Primary practice location

15300 West Ave
Orland Park, IL 60462-4600

Mailing address

12251 S 80TH Ave Ste 1630
Palos Heights, IL 60463-1256
Phone (708) 923-5173

Other identifiers 1

IdentifierTypeStateIssuer
036075762MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060622000175 IL Practitioner - Internal Medicine 9436161080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

15300 W Ave BLDG a
Suite 100
Orland Park, IL 60462-4600
Phone (708) 226-2626

1800 N Main St
Wheaton, IL 60187-3112
Phone (630) 933-4800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group Internal Medicine CurrentSince Sep 1, 2021 Accepting new patients
Central Dupage Physician Group CurrentSince Sep 1, 2021 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

15300 West Ave
Orland Park, IL 60462
Phone (708) 226-2440

15300 West Ave
Ste 222
Orland Park, IL 60462
Phone (708) 364-1050

15300 West Ave
Ste 223
Orland Park, IL 60462
Phone (708) 226-2440

12251 S 80th Ave
Palos Heights, IL 60463
Phone (708) 361-4500

12251 S 80th Ave
Ste 1630
Palos Heights, IL 60463
Phone (708) 923-5173

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Organizations & group practices 2

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 8

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1760430557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12251 S 80TH AVE STE 1630",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631256",
            "telephone_number": "708-923-5173",
            "fax_number": "708-923-5018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15300 WEST AVE",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604624600",
            "telephone_number": "708-923-7874",
            "fax_number": "708-923-7876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKDAH",
        "first_name": "SALEM",
        "middle_name": "JAD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "deactivation_date": "2018-08-27",
        "reactivation_date": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036075762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036075762",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.