1. Home
  2. Directory
  3. Illinois
  4. Burbank
  5. Internal Medicine
  6. NPI Profile

BURBANK MEDICAL GROUP INC
NPI 1508107061
Internal Medicine in Burbank, IL

Active since March 08, 2013CLIA 14D2055237 · Waiver
4817 W 83RD ST, BURBANK, IL 60429(708) 425-3135(708) 425-6884 Get Directions Write a Review

NPPES record last updated: March 8, 2013. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Burbank Medical Group Inc NPPES

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

BURBANK MEDICAL GROUP INC (NPI 1508107061) is a healthcare organization registered as an internal medicine in Burbank, Illinois and active in the NPI registry since March 2013. The organization holds a CLIA Waiver certificate valid through March 6, 2027 and lists Jalal Dahshe, Provider, as its authorized official.

NPPES Registry Identity

NPI1508107061
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameBURBANK MEDICAL GROUP INC
Location Address4817 W 83RD STBurbank, IL 60429
Mailing Address9229 Massasoit AveOak Lawn, IL 60453 · (708) 422-2023 · Fax (708) 423-2991
Phone(708) 425-3135
Fax(708) 425-6884
Organization SubpartNo
Authorized OfficialJalal DahsheProvider · (708) 425-3135
Enumeration DateMarch 8, 2013
✔ NPI 1508107061 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in IL · 036088926
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
4817 W 83RD ST, Burbank, IL 60429
Open in Google Maps ↗

Other Identifiers 1

Medicaid030088926IL

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)

Burbank Medical Group Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Burbank Medical Group Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Jalal Dahshe, MD
Internal Medicine
NPI 1790716967
4817 W 83RD ST
Burbank, IL 60459
(708) 425-3135
✔ PECOS✔ Accepts MedicareSame address

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 Waiver 14D2055237

Burbank Medical Group · Burbank, IL
Active · expires Mar 6, 2027
CLIA Number14D2055237
Laboratory TypePhysician Office
Certificate Effective DateMarch 7, 2025
Certificate Expiration DateMarch 6, 2027
Laboratory DirectorJalal Dahshe
Laboratory Phone(708) 658-6004
Laboratory LocationBurbank Medical Group4817 West 83rd St, Ste 2, Burbank, IL 60459
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

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 Burbank Medical Group Inc's NPI number?

The NPI number for Burbank Medical Group Inc is 1508107061. It was assigned to this organization in the NPPES registry on March 8, 2013.

Where is Burbank Medical Group Inc located?

Burbank Medical Group Inc is located at 4817 W 83rd St, Burbank, IL 60429. The listed phone number is (708) 425-3135.

What is Burbank Medical Group Inc's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Burbank Medical Group Inc enrolled in Medicare?

Yes. Burbank Medical Group Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Burbank Medical Group Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Burbank Medical Group Inc. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Burbank Medical Group Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2055237) is associated with this NPI, valid through March 6, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Burbank Medical Group Inc was last updated on March 8, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years 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.