Individual provider Active NPI

Ayman Rawda, MD

  • Pediatrics Physician
  • Oak Lawn, IL
National Provider Identifier
1902911050
Registry record updated Aug 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036119571 Issued in ID
Practice address
9939 Southwest Hwy
Oak Lawn, IL 60453-3767
Phone
(708) 424-0900
Fax
(708) 424-1715
NPI assigned
Aug 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036119571 ID Primary

Addresses

Primary practice location

9939 Southwest Hwy
Oak Lawn, IL 60453-3767

Mailing address

9939 Southwest Hwy
Oak Lawn, IL 60453-3767
Phone (708) 424-0900

Other identifiers 2

IdentifierTypeStateIssuer
036119517MedicaidIL
748195000MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100626000095 IL Practitioner - Pediatric MedicinePractitioner - General PracticePractitioner - Internal Medicine 0941205611 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036119571IDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Jun 3, 2017 Accepting new patients
Pediatrics on Demand, Inc. Pediatrics Current Accepting new patients
Minis Inc Pediatrics Past Accepting new patients
Advocate North Side Health Network Past Accepting new patients

Locations

9939 Southwest Hwy
Oak Lawn, IL 60453
Phone (708) 424-0900

9930 Southwest Hwy
Oak Lawn, IL 60453
Phone (708) 424-0900

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

5666 E State St
Rockford, IL 61108
Phone (815) 226-2000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3895/brand/1/csg/1/fhir/r4
  • Direct secure messaging: arawda181572@uchospital.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472515200000",
    "number": "1902911050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9939 SOUTHWEST HWY",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604533767",
            "telephone_number": "708-424-0900",
            "fax_number": "708-424-1715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9939 SOUTHWEST HWY",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604533767",
            "telephone_number": "708-424-0900",
            "fax_number": "708-424-1715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAWDA",
        "first_name": "AYMAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2016-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ID",
            "license": "036119571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036119517",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "748195000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

Verify at the official NPI Registry.