KIDDOS HEALTH SC NPI 1558759738

NPI Information

NPI: 1558759738
Provider Name: KIDDOS HEALTH, SC
Classification: Pediatrics - 2080P0202X
Specialization: Pediatric Cardiology
Entity Type: Organization
Former Legal Business Name: AXIOM CLINIC
CLIA Number: 14D2322652
Address: 3 YORKTOWN SHOPPING CTR
LOMBARD, IL
ZIP 60148
Phone: (630) 520-5990

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NPI Details

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 CLIA number assigned to this NPI record is 14D2322652 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/22/2014 and was last updated on 1/1/2025.

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	103K00000X	Behavior Analyst				No
2	104100000X	Social Worker				No
3	106E00000X	Assistant Behavior Analyst				No
4	208000000X	Pediatrics				No
5	2080P0202X	Pediatrics	Pediatric Cardiology	036105004	ILLINOIS	Yes
6	2080P0214X	Pediatrics	Pediatric Pulmonology			No
7	2084N0402X	Psychiatry & Neurology	Neurology with Special Qualifications in Child Neurology			No
8	225X00000X	Occupational Therapist				No
9	235Z00000X	Speech-Language Pathologist				No
10	261QM0855X	Clinic/Center	Adolescent and Children Mental Health			No
11	261QU0200X	Clinic/Center	Urgent Care			No
12	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: 11/21/2025

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