NPIMap

Individual provider Active NPI

Mariam Anis, M.D.

  • Pulmonary Disease Physician
  • Lake Forest, IL
National Provider Identifier
1013274349
Registry record updated Oct 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
036142926 Issued in IL
Practice address
1000 N Westmoreland Rd # Level1
Lake Forest, IL 60045-1658
Phone
(847) 535-7647
Fax
(847) 535-7151
NPI assigned
Apr 11, 2012
Last updated
Oct 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35.126029 OH
Pulmonary Disease Physician 207RP1001X 036142926 IL Primary

Addresses

Primary practice location

1000 N Westmoreland Rd # Level1
Lake Forest, IL 60045-1658

Mailing address

1000 N Westmoreland Rd # Level1
Lake Forest, IL 60045-1658
Phone (847) 535-7647

Other practice location 1

234 Goodman St
Cincinnati, OH 45219-2364
Phone (513) 584-4505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210929000484 IL Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 2668607052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1000 N Westmoreland Rd
Lake Forest, IL 60045-1658
Phone (847) 234-5600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2021 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2021 Accepting new patients
Central Dupage Physician Group Internal Medicine Past Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

1000 N Westmoreland Rd
Lake Forest, IL 60045
Phone (847) 535-6150

1000 N Westmoreland Rd
#1
Lake Forest, IL 60045
Phone (847) 534-3278

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Interoperability endpoints

  • Direct secure messaging: manis17802@uihealth.direct-ci.com

Organizations & group practices 3

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

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": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1013274349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N WESTMORELAND RD # LEVEL1",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451658",
            "telephone_number": "847-535-7647",
            "fax_number": "847-535-7151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N WESTMORELAND RD # LEVEL1",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451658",
            "telephone_number": "847-535-7647",
            "fax_number": "847-535-7151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "234 Goodman St",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452192364",
            "country_code": "US",
            "telephone_number": "513-584-4505",
            "fax_number": "513-584-0468",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANIS",
        "first_name": "MARIAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-11",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.126029",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036142926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, IL

Sources for this page

Verify at the official NPI Registry.