Individual provider Active NPI

Safia Fahad, MD

  • Nephrology Physician
  • Chicago, IL
National Provider Identifier
1083321202
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
COVIDIMG1812 Issued in IL
Practice address
2740 W Foster Ave Ste 105
Chicago, IL 60625-3547
Phone
(773) 784-2101
NPI assigned
Oct 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X COVIDIMG1812 IL Primary

Addresses

Primary practice location

2740 W Foster Ave Ste 105
Chicago, IL 60625-3547

Mailing address

4564 Basswood Dr
Lisle, IL 60532-1374
Phone (847) 630-1883

Other names 1

  • Safia Zaheeruddin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20231204001698 NY Practitioner - Internal Medicine 9931557832

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.25 of 100Reported as group
Quality
85.66
Promoting interoperability
100
Improvement activities
40
Cost
65.17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
COVIDIMG1812ILMDNephrology Physician

NPI Registry JSON

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

{
    "created_epoch": "1666915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1083321202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4564 BASSWOOD DR",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321374",
            "telephone_number": "847-630-1883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 W FOSTER AVE STE 105",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253547",
            "telephone_number": "773-784-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAHAD",
        "first_name": "SAFIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-28",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "COVIDIMG1812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAFIA",
            "last_name": "ZAHEERUDDIN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.