Issam Moussa Maatouk, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036-086819 Issued in IL

Practice address

7301 N Lincoln Ave Ste 183
Lincolnwood, IL 60712-1736

Phone

(224) 766-7669

NPI assigned

Feb 16, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: issam.m@ohis-il.direct.office.nextgen.com

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Excel Care Health Services Inc

  • Home Health Agency
  • Lincolnwood, IL
  • NPI 1366455438

  5% Or Greater Indirect Ownership Interest, W-2 Managing Employee

  CMS ownership

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.

• Excel Care Health Services Inc

  • Home Health Agency
  • Lincolnwood, IL
  • NPI 1366455438
  NPD Authorized official
• Onsite Health Therapies, LLC

  • Physical Therapist
  • Lincolnwood, IL
  • NPI 1790373454
  NPD Authorized official
• Advanced Woundcare, Inc

  • General Practice Physician
  • Skokie, IL
  • NPI 1447821459
  Medicare reassignment
• Onsite Durable Medical Equipment Inc.

  • Durable Medical Equipment & Medical Supplies
  • Lincolnwood, IL
  • NPI 1033609870
  NPD

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1013051705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3926 W TOUHY AVE",
            "address_2": "# 372",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607121028",
            "telephone_number": "847-810-9095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 N LINCOLN AVE STE 183",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607121736",
            "telephone_number": "224-766-7669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAATOUK",
        "first_name": "ISSAM",
        "middle_name": "MOUSSA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01041801A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-086819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "NextGen",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "address_1": "7301 N Lincoln Ave Ste 183",
            "city": "Lincolnwood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "607121736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• June Loredo
• Luxottica of America Inc.
• Rhianna Lynn
• Lyric National
• M. a. Clark, Inc
• Ruba M Maatouk, DDS
• Maison Trao Inc
• Elly Mak, M.D.
• Ayesha Malik
• Noa Chana Malkin, LSW

• Internal Medicine Physician in Lincolnwood, IL
• Providers in Lincolnwood, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.