CMS-1500 Box 24J / 33a • NPI
1700058898
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
207R00000X (CMS 11)
Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician)
Box 32 Service Location & ZIP+4
4817 W 83RD ST, BURBANK, IL, 60459-2790
✓ 9-Digit EDI 837 ZIP+4 (60459-2790)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1700058898 (BURBANK MEDICAL CENTER SC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1700058898 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | BURBANK MEDICAL CENTER SC |
| Plain-English Specialty | Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) NUCC Code: 207R00000X (Internal Medicine) |
| Certifying / Licensing Body | American Board of Internal Medicine (ABIM) |
| Practice Location Address | 4817 W 83RD ST, BURBANK, IL, 60459-2790 |
| Practice Telephone / Fax | Tel: (708) 425-3135 | Fax: (708) 425-6884 |
| Administrative Mailing Address | 4817 W 83RD ST, BURBANK, IL, 60459-2790 |
| Enumeration & Last Sync | Enumerated: 2008-03-28 | CMS Record Updated: 2008-07-10 |
| Authorized Official | JALAL DAHSHE (President) |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (207R00000X)
What Does Taxonomy Code 207R00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207R00000X translates to:
"Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (BURBANK MEDICAL CENTER SC)
Typical CPT / Diagnostic Procedures:- Complex Multi-System Adult Diagnostic Workup (CPT 99204–99215)
- Preoperative Medical Risk Assessment & Cardiac Clearance
- Chronic Kidney, Hepatic & Metabolic Panel Interpretation
- Adult Inpatient Hospitalist Management & Discharge Coordination
- Antihypertensives (ACE Inhibitors, ARBs, Calcium Channel Blockers, Thiazides)
- Oral Antidiabetic Agents, Basal/Bolus Insulins & Lipid-Lowering Statins
- Direct Oral Anticoagulants (Apixaban, Rivaroxaban) & Antiplatelets
- Levothyroxine (Hypothyroidism) & Proton Pump Inhibitors (Pantoprazole)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
207V00000X — Obstetrics & GynecologyPlain English: Board-Certified Obstetrician & Gynecologist (Women's Health & Pregnancy Doctor) | State: IL | License: 036054337 | Primary: Secondary |
213E00000X — PodiatristPlain English: Licensed & Credentialed Podiatric Medicine & Surgery Service Providers — Podiatrist | State: IL | License: 016002638 | Primary: Secondary |
207R00000X — Internal MedicinePlain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) | State: IL | License: 036088926 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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