Randa Nakib

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019030807 Issued in IL

Practice address

2158 W Cermak Rd
Chicago, IL 60608-4040

Phone

(773) 823-9124

NPI assigned

Jul 13, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1468368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468368000000",
    "number": "1932551058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2158 W CERMAK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606084040",
            "telephone_number": "773-823-9124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2158 W CERMAK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606084040",
            "telephone_number": "773-823-9124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKIB",
        "first_name": "RANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-13",
        "last_updated": "2016-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019030807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sanaa Nakad Borrego, MD
• Caroline Nakahara
• Brad Keola Katsuichi Nakamura
• Mayumi Nakamura, PSY.D.
• Takanobu Nakaseko, D.C.
• Nakisher Psychological Services, PLLC
• Steven M Nakisher, PSYD
• Danae E Nakoneczny, M.D.
• Megan Nakum
• Ruzanna Nalbandyan, M.D.

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.