AXIOM CLINIC, SC (NPI# 1558759738) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558759738 |
| Entity Type | Organization |
| Organization Name | AXIOM CLINIC, SC |
| Other Organization Name | KIDS HEART CLINIC |
| Practice Address |
4202 Forest Ave Downers Grove IL 60515-2049 |
| Practice Telephone | 3167373602 |
| Mailing Telephone | 3167373602 |
| Enumeration Date | 2014-12-22 |
| Last Update Date | 2014-12-22 |
| Authorized Official Name | MOHAMAD AL-AHDAB (PRESIDENT) |
| Authorized Official Telephone | 3167373602 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
036105004 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | 200414260C | 05 |
| Other Name | Type Code |
|---|---|
| Kids Heart Clinic | Doing Business As Name - Organization |
| Street Address |
4202 FOREST AVE |
| City | DOWNERS GROVE |
| State | IL |
| Zip Code | 60515-2049 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811594906 | Everyday Empowered Clinical Services, Ltd. | Community/Behavioral Health | 5117 Main St, Suite #7, Downers Grove, IL 60515 | 2020-10-02 |
| 1588122568 | Jennifer Solis-english | Family Medicine | Physician Office Center, Tower 2, 3825 Highland Avenue Suite 306, Downers Grove, IL 60515 | 2019-03-07 |
| 1679039358 | Remedi Seniorcare of Chicago, LLC | Pharmacy | 3600 Lacey Road, Suite 500, Downers Grove, IL 60515 | 2019-02-18 |
| 1639651094 | Ann Marie Olson | Occupational Therapy Assistant | 3450 Saratoga Ave., Downers Grove, IL 60515 | 2018-09-02 |
| 1598242802 | Angela Gathings | Nurse Practitioner | 1020 31st St, Downers Grove, IL 60515 | 2018-07-20 |
| 1013408194 | Amer Shammaa | Dentist | 1008 Braemoor Dr, Downers Grove, IL 60515 | 2018-05-23 |
| 1174020994 | Leslie A Kula-leitner | Social Worker | Alder Grove Counseling, 4923 Main Street, Downers Grove, IL 60515 | 2018-04-09 |
| 1588176390 | Tammy Marie Tunac | Counselor | 2001 Butterfield Road, Suite 320, Downers Grove, IL 60515 | 2017-11-02 |
| 1366976466 | Giannasi Mental Health Counselors | Counselor | 921 Curtiss Street, Downers Grove, IL 60515 | 2017-04-14 |
| 1194258079 | Alyssa Stylski | Dentist | 2001 Butterfield Rd Ste 140, Downers Grove, IL 60515 | 2017-04-06 |
| Find all providers in zip 60515 | ||||
| Taxonomy Code | 2080P0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Cardiology |
| A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518032739 | Illinois Institute of Pediatric Cardiology | Pediatrics | 1202n 75th St, Ste 270, Downers Grove, IL 60516-4274 | 2006-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386187458 | A2z Care Med-peds Specialists, PC | Pediatrics | 550 East Bougton Road, Suite 110, Bolingbrook, IL 60440-2194 | 2016-11-22 |
| 1003369836 | Peter Varga Md Sc | Pediatrics | 317 N Euclid Ave, Oak Park, IL 60302-2109 | 2016-07-28 |
| 1699153791 | Siddharth Dubey | Pediatrics | 400 N 9th St Fl 2, Springfield, IL 62702-5310 | 2015-05-11 |
| 1265853170 | Leo Henikoff Jr. | Pediatrics | 1437 W Lexington St, Chicago, IL 60607-4013 | 2013-12-18 |
| 1932425188 | Amy Marie O'connor | Pediatrics | 225 E Chicago Ave # 21, Chicago, IL 60611-2991 | 2010-04-13 |
| 1376709519 | Sanmit Kumar Basu | Pediatrics | 5841 S Maryland Ave # Mc4051, Chicago, IL 60637-1443 | 2008-08-06 |
| 1104012053 | Mukesh M. Doshi, M.d., S.c. | Pediatrics | 1768 Moon Lake Blvd, Suite 206, Hoffman Estates, IL 60169 | 2007-09-24 |
| 1740483627 | Priti M. Patel | Pediatrics | 530 Ne Glenoak Ave, Peoria, IL 61603-3133 | 2007-06-07 |
| 1134241383 | Ep Consultation, Ltd | Pediatrics | 910 W Van Buren St, Ste 226, Chicago, IL 60607-3523 | 2007-04-06 |
| 1487787818 | Fairview Heights Medical Group Sc | Pediatrics | 11th and Broadway, 4th Floor, Quincy, IL 62301 | 2007-03-14 |
| Find all providers with the same taxonomy | ||||
| City | DOWNERS GROVE |
| Zip Code | 60515 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.