Individual
DR. HYTHEM P SHADID
Active
Individual
DR. HYTHEM P SHADID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
036082388
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036082388
—
IL
01
—
04525539
BCBS PROVIDER #
IL
01
—
1477567394
GROUP NPI
IL
01
—
200038958
MEDICARE RAILROAD (PTAN)
IL
01
—
364333655
TAX ID#
IL
01
—
3643336556019001
HFS PAYEE ID
IL
01
—
DO4326
GROUP PTAN
IL
Enumeration date
07/28/2006
Last updated
04/20/2012
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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