Active NPI
Farkhunda Mazharuddin, MD
- Family Medicine Physician
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036065434
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036065434 | Medicaid | IL | |
| 31601508 | Other | IL | BCBS |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090209000345 | IL | Practitioner - General Practice | 3577628544 | Practice locations: Chicago, IL |
Care Compare profile
Medicare Care Compare- Specialty
- General Practice
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 036065434 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dawn Diagnostics Imaging Group Inc. | Current | Accepting new patients | |
| SBK Medical Inc | Current | 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.
-
- Diagnostic Radiology Physician
- Skokie, IL
- NPI 1174839575
-
- Diagnostic Radiology Physician
- Chicago, IL
- NPI 1124837034
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Chicago, IL
- NPI 1932295185
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.