| 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 | 37 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 |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Genesis Orthopedics And Sports Medicine Llc | 7618955808 | 18 |
| 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 |
Jonathan Wang, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 2900 Foxfield Rd Ste 102, St Charles, IL 60174 Phone: 877-377-1188 Fax: 630-377-7360 | |
Dr. Jeffrey W Grosskopf, M.D. Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 3805 E. Main Street, Suite G, St Charles, IL 60174 Phone: 630-402-2128 Fax: 630-397-7814 |