Active NPI
Yaser A. Maksoud
- Surgical Physician Assistant
- Oak Lawn, IL
National Provider Identifier
1902048788
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 238.000220
- Practice address
- 4440 W 95TH St
Oak Lawn, IL 60453-2600 - Phone
- (708) 684-8000
- NPI assigned
- Mar 25, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 238.000220 | IL | Primary |
Addresses
Primary practice location
4440 W 95TH St
Oak Lawn, IL 60453-2600
Mailing address
8534 Thomas Charles LN
Hickory Hills, IL 60457-4101
Phone (312) 731-4949
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 238.000220 | IL | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1237939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1238025600000",
"number": "1902048788",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8534 THOMAS CHARLES LN",
"city": "HICKORY HILLS",
"state": "IL",
"postal_code": "604574101",
"telephone_number": "312-731-4949",
"fax_number": "708-496-6466"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4440 W 95TH ST",
"city": "OAK LAWN",
"state": "IL",
"postal_code": "604532600",
"telephone_number": "708-684-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAKSOUD",
"first_name": "YASER",
"middle_name": "A.",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-03-25",
"last_updated": "2009-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "IL",
"license": "238.000220",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Lawn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.