Dr Hythem P Shadid, MD | |
2900 Foxfield Rd, Suite 102, St Charles, IL 60174-5799 | |
(630) 377-1188 | |
(630) 377-7360 |
Full Name | Dr Hythem P Shadid |
---|---|
Gender | Male |
Speciality | Orthopedic Surgery |
Experience | 36 Years |
Location | 2900 Foxfield Rd, St Charles, Illinois |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1477567394 | NPI | - | NPPES |
1477567394 | Other | IL | GROUP NPI |
3643336556019001 | Other | IL | HFS PAYEE ID |
DO4326 | Other | IL | GROUP PTAN |
04525539 | Other | IL | BCBS PROVIDER # |
200038958 | Other | IL | MEDICARE RAILROAD (PTAN) |
036082388 | Medicaid | IL | |
364333655 | Other | IL | TAX ID# |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207XX0005X | Orthopaedic Surgery - Sports Medicine | 036082388 (Illinois) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Vista Medical Center East | Waukegan, IL | Hospital |
Central Dupage Hospital | Winfield, IL | Hospital |
Norwegian-american Hospital | Chicago, IL | Hospital |
Advocate Good Samaritan Hospital | Downers grove, IL | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Genesis Orthopedics And Sports Medicine Llc | 7618955808 | 13 |
Entity Name | Genesis Orthopedics & Sports Medicine Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1346389061 PECOS PAC ID: 7618955808 Enrollment ID: O20040713001038 |
Entity Name | Waukegan Clinic Corp |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1306937289 PECOS PAC ID: 4284631086 Enrollment ID: O20061108000240 |
Mailing Address | Practice Location Address |
---|---|
Dr Hythem P Shadid, MD 2900 Foxfield Rd, Suite 102, St Charles, IL 60174-5799 Ph: (630) 377-1188 | Dr Hythem P Shadid, MD 2900 Foxfield Rd, Suite 102, St Charles, IL 60174-5799 Ph: (630) 377-1188 |
Dr. Jeffrey W Grosskopf, M.D. Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 3805 E. Main Street, Suite G, St Charles, IL 60174 Phone: 630-402-2128 Fax: 630-397-7814 |