Individual provider Active NPI

Azazuddin A Ahmed, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1073732459
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Practice address
1901 W Harrison St
Chicago, IL 60612-3714
Phone
(312) 864-6000
NPI assigned
Apr 24, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X IL Primary

Addresses

Primary practice location

1901 W Harrison St
Chicago, IL 60612-3714

Mailing address

11 Sylvan Glen CT
Burr Ridge, IL 60527-0703
Phone (630) 920-9956

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
I20070523000022 IL Practitioner - Internal MedicinePractitioner - Nephrology 1456458611 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chandra Diagnostic Cardiology LTDGroup PAC ID 4082509252, 4 clinicians

Practice addresses (Care Compare)

10718 S Ewing Ave
Chicago, IL 60617-6605
Phone (773) 731-5456

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Chandra Diagnostic Cardiology LTD CurrentSince Oct 15, 2021 Accepting new patients
Cook County Current Accepting new patients
Chandra Diagnostic Cardiology LTD Current Accepting new patients
Cook County Internal Medicine CurrentSince Nov 4, 2010 Accepting new patients
Cook County CurrentSince Nov 4, 2010 Accepting new patients

Locations

10718 S Ewing Ave
Chicago, IL 60617
Phone (773) 731-5456

1900 W Polk St
Rm G16
Chicago, IL 60612

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

4250 N Marine Dr
Ste 236
Chicago, IL 60613
Phone (773) 572-5238

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

3330 W 177th St
Ste 3E
Hazel Crest, IL 60429
Phone (708) 798-4500

Organizations & group practices 5

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073732459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 SYLVAN GLEN CT",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605270703",
            "telephone_number": "630-920-9956",
            "fax_number": "630-920-1902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123714",
            "telephone_number": "312-864-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "AZAZUDDIN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.