Individual provider Active NPI

Ahmed Mohamed, R.P.T, MS

  • Physical Therapist
  • Oak Lawn, IL
National Provider Identifier
1801805148
Registry record updated Aug 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070-009262 Issued in IL
Practice address
6060 W 95TH St
Oak Lawn, IL 60453-2778
Phone
(708) 952-1052
Fax
(708) 952-1053
NPI assigned
Aug 5, 2006
Last updated
Aug 13, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070-009262 IL Primary

Addresses

Primary practice location

6060 W 95TH St
Oak Lawn, IL 60453-2778

Mailing address

10448 S Pulaski Rd
Suite 4&5
Oak Lawn, IL 60453-4895
Phone (708) 952-1052

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040715000884 IL Practitioner - Physical Therapist in Private Practice 7315928660 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
070-009262ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Faith Home Health Care, Inc. Current Accepting new patients
Residential Clinical Services, Inc. Current Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Faith Home Health Care, Inc.Chicago, IL, CCN 148023 Home health agency 5% Or Greater Indirect Ownership Interest (25%)
Corporate Director (25%)
Operational/Managerial Control (25%)
Oct 25, 2020
Oct 25, 2020
Oct 25, 2020
Residential Clinical Services, Inc.Merrillville, IN, CCN 157116 Home health agency 5% Or Greater Direct Ownership Interest (25%)
Corporate Officer (25%)
W-2 Managing Employee (100%)
Aug 31, 2014
Aug 31, 2014
Aug 31, 2014

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1801805148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10448 S PULASKI RD",
            "address_2": "SUITE 4&5",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604534895",
            "telephone_number": "708-952-1052",
            "fax_number": "708-952-1053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6060 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532778",
            "telephone_number": "708-952-1052",
            "fax_number": "708-952-1053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMED",
        "first_name": "AHMED",
        "credential": "R.P.T, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-009262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

Verify at the official NPI Registry.