Saeid Mojtahedi, MD.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

036058145 Issued in IL

Practice address

180 Harvester Dr Ste 110
Burr Ridge, IL 60527-6686

Phone

(773) 834-4064

NPI assigned

Jan 16, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352851200000",
    "number": "1881745859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE # MC1099",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 HARVESTER DR STE 110",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605276686",
            "telephone_number": "773-834-4064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOJTAHEDI",
        "first_name": "SAEID",
        "name_prefix": "Dr.",
        "credential": "MD.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2012-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036058145",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036058145",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kenneth Lawrence Moore, M.D.
• Andrew Joseph Moormann, D.D.S.
• Morack Inc

• Diagnostic Radiology Physician in Burr Ridge, IL
• Providers in Burr Ridge, IL by specialty
• Diagnostic Radiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.