Individual provider Active NPI

Farkhunda Mazharuddin, MD

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1023181088
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036065434 Issued in IL
Practice address
2321 W Devon Ave
Chicago, IL 60659-2003
Phone
(773) 465-3500
Fax
(844) 364-6372
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036065434 IL Primary

Addresses

Primary practice location

2321 W Devon Ave
Chicago, IL 60659-2003

Mailing address

2321 W Devon Ave
Chicago, IL 60659-2003
Phone (773) 465-3500

Other practice location 1

7311 N Kenneth Ave
Lincolnwood, IL 60712-1806
Phone (773) 278-8727

Other identifiers 2

IdentifierTypeStateIssuer
036065434MedicaidIL
31601508OtherILBCBS

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL CHICAGO Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090209000345 IL Practitioner - General PracticePractitioner - Family PracticePractitioner - Internal Medicine 3577628544 Practice locations: Chicago, IL

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Family Practice, Internal Medicine
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1802 W Chicago Ave
Chicago, IL 60622-5512
Phone (773) 278-8727

2321 W Devon Ave
Chicago, IL 60659-2003
Phone (773) 465-3500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036065434ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dawn Diagnostics Imaging Group Inc. CurrentSince Aug 18, 2024 Accepting new patients
SBK Medical Inc CurrentSince Jan 1, 2025 Accepting new patients

Locations

6422 N Western Ave
Chicago, IL 60645
Phone (773) 465-3500

2321 W Devon Ave
Chicago, IL 60659
Phone (630) 563-1006

Organizations & group practices 2

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 1

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": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1023181088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2321 W DEVON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606592003",
            "telephone_number": "773-465-3500",
            "fax_number": "844-364-6372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2321 W DEVON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606592003",
            "telephone_number": "773-465-3500",
            "fax_number": "844-364-6372"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7311 N Kenneth Ave",
            "address_purpose": "LOCATION",
            "city": "Lincolnwood",
            "state": "IL",
            "postal_code": "607121806",
            "country_code": "US",
            "telephone_number": "773-278-8727",
            "fax_number": "773-637-2006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAZHARUDDIN",
        "first_name": "FARKHUNDA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036065434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036065434",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "31601508",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "CHICAGO",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1802 W Chicago Ave Ste 5",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606225512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.