Active NPI
Skyline Healthcare
- Internal Medicine Physician
- Niles, IL
National Provider Identifier
1972324200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- SKYLINE HEALTHCARE
- Practice address
- 8712 N Olcott Ave
Niles, IL 60714-2024 - Phone
- (708) 942-4785
- NPI assigned
- Oct 19, 2024
- Last updated
- Oct 19, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Sufyan Abdulmujeeb, DO
- Title
- Owner
- Phone
- (708) 942-4785
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary | ||
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X |
Addresses
Primary practice location
8712 N Olcott Ave
Niles, IL 60714-2024
Mailing address
8712 N Olcott Ave
Niles, IL 60714-2024
Phone (708) 942-4785
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 6
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.
-
- Internal Medicine Physician
- Niles, IL
- NPI 1013478452
-
- Internal Medicine Physician
- Chicago, IL
- NPI 1215630405
-
- Family Nurse Practitioner
- Chicago, IL
- NPI 1538844626
-
- Acute Care Nurse Practitioner
- Plano, IL
- NPI 1114484185
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1729296000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1729296000000",
"number": "1972324200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8712 N OLCOTT AVE",
"city": "NILES",
"state": "IL",
"postal_code": "607142024",
"telephone_number": "708-942-4785"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8712 N OLCOTT AVE",
"city": "NILES",
"state": "IL",
"postal_code": "607142024",
"telephone_number": "708-942-4785"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SKYLINE HEALTHCARE",
"organizational_subpart": "NO",
"enumeration_date": "2024-10-19",
"last_updated": "2024-10-19",
"certification_date": "2024-10-16",
"status": "A",
"authorized_official_last_name": "ABDULMUJEEB",
"authorized_official_first_name": "SUFYAN",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "708-942-4785",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DO"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207RG0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Geriatric Medicine",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Niles, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.