Individual provider Active NPI

Faiyaaz Ahmad Kalimullah, M.D.

  • Dermatology Physician
  • Chicago, IL
National Provider Identifier
1063729895
Registry record updated Feb 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
036139965 Issued in IL
Practice address
755 N Wells St
Suite 201
Chicago, IL 60654-3520
Phone
(312) 380-6747
Fax
(312) 348-7229
NPI assigned
Aug 31, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 036139965 IL Primary

Addresses

Primary practice location

755 N Wells St
Suite 201
Chicago, IL 60654-3520

Mailing address

755 N Wells St
Suite 201
Chicago, IL 60654-3520
Phone (312) 380-6747

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
I20161214000897 IL Practitioner - Dermatology 9739409582 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Rush Medical College of Rush University, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians
Center for Dermatology and Aesthetic Medicine LLCGroup PAC ID 3678860087, 2 clinicians

Practice addresses (Care Compare)

1700 W Van Buren St
Chicago, IL 60612-5500
Phone (312) 563-2875

1725 W Harrison St
Chicago, IL 60612-3844

755 N Wells St
Suite 201
Chicago, IL 60654-3596
Phone (312) 380-6747

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions13
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Center Dermatology CurrentSince Oct 1, 2020 Accepting new patients
Center for Dermatology and Aesthetic Medicine, LLC Dermatology CurrentSince Jan 30, 2017 Accepting new patients
Rush University Medical Group Dermatology CurrentSince Oct 1, 2020 Accepting new patients

Locations

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

755 N Wells St
Ste 201
Chicago, IL 60654
Phone (312) 280-6747

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1725 W Harrison St
Ste 264
Chicago, IL 60612
Phone (312) 942-2195

Interoperability endpoints

  • Direct secure messaging: fkalimullah11508@direct.rush.rush-health.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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1283212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487030400000",
    "number": "1063729895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 N WELLS ST",
            "address_2": "SUITE 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606543520",
            "telephone_number": "312-380-6747",
            "fax_number": "312-348-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 N WELLS ST",
            "address_2": "SUITE 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606543520",
            "telephone_number": "312-380-6747",
            "fax_number": "312-348-7229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALIMULLAH",
        "first_name": "FAIYAAZ",
        "middle_name": "AHMAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-31",
        "last_updated": "2017-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036139965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.