NPIMap

Individual provider Active NPI

Haider A Shirazi, M.D.

  • Radiation Oncology Physician
  • Tinley Park, IL
National Provider Identifier
1821254731
Registry record updated Aug 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
036123178 Issued in IL
Practice address
17333 La Grange Rd
Suite 100
Tinley Park, IL 60487-7502
Phone
(708) 448-9393
Fax
(708) 448-7530
NPI assigned
Jul 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 125051665 IL
Radiation Oncology Physician 2085R0001X 036123178 IL Primary

Addresses

Primary practice location

17333 La Grange Rd
Suite 100
Tinley Park, IL 60487-7502

Mailing address

17333 La Grange Rd
Suite 100
Tinley Park, IL 60487-7502
Phone (708) 448-9393

Other identifiers 2

IdentifierTypeStateIssuer
036123178MedicaidIL
125051665OtherILTEMPORARY LICENSE IN ILLINOIS

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
I20110707000497 IL Practitioner - Radiation Oncology 5698953073 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Stanford University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

12251 S 80TH Ave
Palos Heights, IL 60463-1290

15300 W Ave
Orland Park, IL 60462-4600

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036123178ILMDRadiation Oncology Physician
125051665ILMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Insight Chicago, Inc. CurrentSince Jun 1, 2022 Accepting new patients
Insight Chicago, Inc. CurrentSince Jun 1, 2022 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2021 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2021 Accepting new patients
Radiation Oncology, SC Radiation Oncology Past Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

2525 S Michigan Ave
Chicago, IL 60616
Phone (312) 355-1153

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

15300 West Ave
Bldg A
Orland Park, IL 60462
Phone (708) 226-2626

17333 La Grange Rd
Ste 100
Tinley Park, IL 60487
Phone (708) 448-9393

Organizations & group practices 6

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

Hospital & facility affiliations 5

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": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375833600000",
    "number": "1821254731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17333 LA GRANGE RD",
            "address_2": "SUITE 100",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604877502",
            "telephone_number": "708-448-9393",
            "fax_number": "708-448-7530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17333 LA GRANGE RD",
            "address_2": "SUITE 100",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604877502",
            "telephone_number": "708-448-9393",
            "fax_number": "708-448-7530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRAZI",
        "first_name": "HAIDER",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-30",
        "last_updated": "2013-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "IL",
            "license": "125051665",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "IL",
            "license": "036123178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036123178",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEMPORARY LICENSE IN ILLINOIS",
            "identifier": "125051665",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinley Park, IL

Sources for this page

Verify at the official NPI Registry.