Individual provider Active NPI

Maria Rustam Latif, MD

  • Hospitalist Physician
  • Joliet, IL
National Provider Identifier
1063620607
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
036125379 Issued in IL
Practice address
2100 Glenwood Ave
Joliet, IL 60435
Phone
(815) 725-2121
NPI assigned
May 18, 2007
Last updated
Aug 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 57.012013 OH
Family Medicine Physician 207Q00000X 036.125379 IL
Hospitalist Physician 208M00000X 036125379 IL Primary

Addresses

Primary practice location

2100 Glenwood Ave
Joliet, IL 60435

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200

Other names 1

  • Maria Rustam Khattak Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mlatif180303@direct.edward.org
Direct Messaging Address mlatif180303@dulyhealthandcare.direct-ci.com

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
I20110119000219 IL Practitioner - Family Practice 6002095395 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

1890 Silver Cross Blvd
Suite 345
New Lenox, IL 60451-9606
Phone (815) 462-9300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.125379ILMDFamily Medicine Physician
57.012013OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Medical Group LTD CurrentSince Aug 20, 2018 Accepting new patients
Dupage Medical Group LTD CurrentSince Aug 20, 2018 Accepting new patients
Haveric Medical LTD CurrentSince Jun 1, 2017 Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

2100 Glenwood Ave
Joliet, IL 60435
Phone (815) 999-3201

333 Madison St
Joliet, IL 60435
Phone (815) 725-7222

1890 Silver Cross Blvd
Ste 345
New Lenox, IL 60451
Phone (815) 462-9300

Interoperability endpoints

  • Direct secure messaging: mlatif180303@direct.edward.org

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 3

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": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1063620607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 GLENWOOD AVE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "60435",
            "telephone_number": "815-725-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATIF",
        "first_name": "MARIA",
        "middle_name": "RUSTAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "57.012013",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.125379",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036125379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlatif180303@direct.edward.org",
            "affiliation": "N",
            "address_1": "2100 Glenwood Ave",
            "city": "Joliet",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60435",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlatif180303@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "2100 Glenwood Ave",
            "city": "Joliet",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "KHATTAK",
            "middle_name": "RUSTAM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Joliet, IL

Sources for this page

Verify at the official NPI Registry.