KIDDOS HEALTH SC NPI 1558759738

NPI Information

NPI: 1558759738
Provider Name: KIDDOS HEALTH, SC

Former Legal Business Name: AXIOM CLINIC

Classification: Pediatrics - 2080P0202X
Entity Type: Organization

Specialization: Pediatric Cardiology

Address:
3 YORKTOWN SHOPPING CTR
LOMBARD, IL
ZIP 60148
Phone: (630) 520-5990
Get Directions

KIDDOS HEALTH, SC is a pediatric cardiology pediatrics in Lombard, IL. The provider is 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. KIDDOS HEALTH, SC NPI is 1558759738. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Axiom Clinic.

The provider's business location address is:

3 YORKTOWN SHOPPING CTR
LOMBARD, IL
ZIP 60148-516
Phone: (630) 520-5990
Fax: (630) 323-9044

The provider's authorized official is Mohamad Khaled Al-ahdab .
The authorized official title is President and has the following contact phone number (316) 440-8800.

The enumeration date for this NPI number is 12/22/2014 and was last updated on 3/29/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208000000X	Pediatrics				No
2	2080P0202X	Pediatrics	Pediatric Cardiology	036105004	ILLINOIS	Yes
3	2080P0214X	Pediatrics	Pediatric Pulmonology			No
4	2084N0402X	Psychiatry & Neurology	Neurology with Special Qualifications in Child Neurology			No
5	261QU0200X	Clinic/Center	Urgent Care			No
6	332B00000X	Durable Medical Equipment & Medical Supplies				No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	036105004	MEDICAID	ILLINOIS
2	200096860A	MEDICAID	OKLAHOMA
3	201276620A	MEDICAID	INDIANA
4	200414260C	MEDICAID	KANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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