Organization Active NPI

SSD Medical Group Inc

  • Internal Medicine Physician
  • Huntley, IL
National Provider Identifier
1932635083
Registry record updated Feb 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SSD MEDICAL GROUP INC
Practice address
12151 Regency Pkwy Ste 12165
Huntley, IL 60142-7644
Phone
(847) 230-9808
Fax
(847) 984-1915
NPI assigned
May 11, 2017
Last updated
Feb 17, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2026

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

Authorized official

Name
Dr. Shazia Daudi, MDNPI 1235137928
Title
President
Phone
(847) 230-9808

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary
Exclusive Provider Organization 302F00000X 336072732 IL

Addresses

Primary practice location

12151 Regency Pkwy Ste 12165
Huntley, IL 60142-7644

Mailing address

12151 Regency Pkwy Ste 12165
Huntley, IL 60142-7644
Phone (847) 230-9808

Other identifiers 1

IdentifierTypeStateIssuer
036111912MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address drdaudi@direct.practicefusion.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170612002768 IL Part B Supplier - Clinic/Group Practice 9032487244 Receives reassigned benefits from 4 practitioners
Practice locations: Huntley, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2136922SSD Medical Group Inc12151 Regency Parkway, Suite 12165, Huntley, IL 60142Certificate of waiverSep 17, 2027

National Provider Directory

National Provider Directory

Locations

12151 Regency Pkwy
Ste 12165
Huntley, IL 60142
Phone (847) 230-9808

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771286400000",
    "number": "1932635083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12151 REGENCY PKWY STE 12165",
            "city": "HUNTLEY",
            "state": "IL",
            "postal_code": "601427644",
            "telephone_number": "847-230-9808",
            "fax_number": "847-984-1915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12151 REGENCY PKWY STE 12165",
            "city": "HUNTLEY",
            "state": "IL",
            "postal_code": "601427644",
            "telephone_number": "847-230-9808",
            "fax_number": "847-984-1915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSD MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "status": "A",
        "authorized_official_last_name": "DAUDI",
        "authorized_official_first_name": "SHAZIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-230-9808",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "IL",
            "license": "336072732",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036111912",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drdaudi@direct.practicefusion.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12151 Regency Pkwy Ste 12165",
            "city": "Huntley",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601427644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntley, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.