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AVID PRIMARY CARE LLC
NPI 1295522688
Family Medicine - Geriatric Medicine in Hazel Crest, IL

Active since April 21, 2025CLIA 14D2343891 · Certificate of Compliance
17465 KEDZIE AVE, HAZEL CREST, IL 60429(708) 887-7329(708) 907-0771 Get Directions Write a Review

NPPES record last updated: July 2, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 22, 2026, Feb 5, 2026, May 19, 2025 and 1 more (4 updates tracked since 2025).

About Avid Primary Care Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AVID PRIMARY CARE LLC (NPI 1295522688) is a healthcare organization registered as a geriatric medicine in Hazel Crest, Illinois and active in the NPI registry since April 2025. The organization holds a CLIA Certificate of Compliance certificate valid through May 12, 2028 and lists Ashraf Anani, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1295522688
Entity TypeOrganization
Primary Taxonomy207QG0300X
Legal Business NameAVID PRIMARY CARE LLC
Location Address17465 KEDZIE AVEHazel Crest, IL 60429-1632
Mailing Address17465 Kedzie AveHazel Crest, IL 60429-1632 · (708) 887-7329 · Fax (708) 907-0771
Phone(708) 887-7329
Fax(708) 907-0771
Organization SubpartNo
Authorized OfficialAshraf AnaniAuthorized Official · (708) 887-7329
Enumeration DateApril 21, 2025
Last NPPES UpdateJuly 2, 20264 updates tracked since enumeration
NPPES CertifiedJuly 2, 2026
✔ NPI 1295522688 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QG0300X
Definition
A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.
17465 KEDZIE AVE, Hazel Crest, IL 60429
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Avid Primary Care Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to Avid Primary Care LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (6)

Siddhi Patel
Nurse Practitioner
NPI 1578499430
17465 KEDZIE AVE
Hazel Crest, IL 60429
(708) 887-7329
✔ PECOSSame address
Geoffrey River, APN
Nurse Practitioner
NPI 1508440371
1749 BROWN AVE
Whiting, IN 46394
(219) 473-1921
✔ PECOS✔ Accepts Medicare12 mi
Amani Qasem, M.D.
Pediatric Medicine
NPI 1114238870
2160 S 1ST AVE
Maywood, IL 60153
(708) 216-9000
✔ PECOS✔ Accepts Medicare21 mi
Johara Hassan, MD
Internal Medicine
NPI 1568417301
223 N WHISPERING HILLS DR
Naperville, IL 60540
(929) 491-1555
✔ PECOS✔ Accepts Medicare29 mi
John Flick, D.O.
Internal Medicine
NPI 1770782351
615 S. NEW BALLAS ROAD
St Louis, MO 63141
(314) 569-6000
✔ PECOS✔ Accepts Medicare248 mi
Ashraf Anani, M.D.
Internal Medicine
NPI 1629041710
201 SETON PKWY
Round Rock, TX 78665
(512) 324-4000
✔ PECOS✔ Accepts Medicare940 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 14D2343891

Avid Primary Care LLC · Hazel Crest, IL
Active · expires May 12, 2028
CLIA Number14D2343891
Laboratory TypePhysician Office
Certificate Effective DateMay 13, 2026
Certificate Expiration DateMay 12, 2028
Laboratory DirectorVishakantha Murthy
Laboratory Phone(708) 887-7329
Laboratory LocationAvid Primary Care LLC17465 Kedzie Ave, Hazel Crest, IL 60429
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Avid Primary Care LLC's NPI number?

The NPI number for Avid Primary Care LLC is 1295522688. It was assigned to this organization in the NPPES registry on April 21, 2025.

Where is Avid Primary Care LLC located?

Avid Primary Care LLC is located at 17465 Kedzie Ave, Hazel Crest, IL 60429. The listed phone number is (708) 887-7329.

What is Avid Primary Care LLC's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Geriatric Medicine, with taxonomy code 207QG0300X.

Is Avid Primary Care LLC enrolled in Medicare?

Yes. Avid Primary Care LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Avid Primary Care LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 3 Medicare specialties reassign their Medicare billing to Avid Primary Care LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Internal Medicine (3), Nurse Practitioner (2) and Pediatric Medicine (1). Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Avid Primary Care LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 14D2343891) is associated with this NPI, valid through May 12, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Avid Primary Care LLC was last updated on July 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.