Individual provider Active NPI

Ithaar Derweesh, MD

  • Urology Physician
  • Chicago, IL
National Provider Identifier
1003873720
Registry record updated Feb 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
036.176621 Issued in IL
Practice address
1725 W Harrison St Ste 970
Chicago, IL 60612-3828
Phone
(312) 563-3447
Fax
(312) 563-3721
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 036.176621 IL Primary

Addresses

Primary practice location

1725 W Harrison St Ste 970
Chicago, IL 60612-3828

Mailing address

1620 W Harrison St
Chicago, IL 60612-3801

Other identifiers 1

IdentifierTypeStateIssuer
3332625MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, MO, IL3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20081205000261 CA Practitioner - Urology 1759310691 Reassigns benefits to 1 organization
I20250829002144 MO Practitioner - Urology 1759310691 Reassigns benefits to 1 organization
I20250918003274 IL Practitioner - Urology 1759310691 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Chicago, Pritzker School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Joplin LLCGroup PAC ID 0547300196, 288 clinicians
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

100 Mercy Way
Joplin, MO 64804-4524

1725 W Harrison St
Suite 970
Chicago, IL 60612-3828
Phone (312) 563-3447

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.77 of 100Reported as group
Quality
84.13
Promoting interoperability
100
Improvement activities
40
Cost
73.88

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.176621ILMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Aug 7, 2008 Accepting new patients
Rush University Medical Group Urology CurrentSince Aug 20, 2025 Accepting new patients
Mercy Clinic Joplin LLC CurrentSince Jun 16, 2025 Accepting new patients
Regents of the University of California Urology CurrentSince Aug 7, 2008 Accepting new patients
Rush University Medical Center CurrentSince Aug 20, 2025 Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients

Locations

3855 Health Sciences Dr
La Jolla, CA 92093
Phone (858) 822-6094

3855 Health Sciences Dr
#987
La Jolla, CA 92093
Phone (858) 534-7079

200 W Arbor Dr
#8897
San Diego, CA 92103
Phone (619) 543-2628

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

1725 W Harrison St
Ste 970
Chicago, IL 60612
Phone (312) 563-3447

1520 W Harrison St
Chicago, IL 60607
Phone (312) 226-2371

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1620 W Harrison St
Chicago, IL 60612
Phone (312) 942-4200

75 Remittance Dr
Dept 1611
Chicago, IL 60675

100 Mercy Way
Ste 530
Joplin, MO 64804
Phone (417) 556-3828

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

Networks

  • IL HMO C-SNP
  • devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806
  • devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
  • IL PPO Downstate
  • devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
  • IA HMO C-SNP
  • devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
  • IA HMO

Interoperability endpoints

  • Direct secure messaging: iderweesh235861@santaclaravalley.direct-ci.net

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771200000000",
    "number": "1003873720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST STE 970",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123828",
            "telephone_number": "312-563-3447",
            "fax_number": "312-563-3721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERWEESH",
        "first_name": "ITHAAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2026-02-16",
        "certification_date": "2026-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "036.176621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3332625",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.