Individual provider Active NPI

Sherriff Alli-Balogun, M.D.

  • Internal Medicine Physician
  • Matteson, IL
National Provider Identifier
1114058617
Registry record updated Jul 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01051719 Issued in IN
Practice address
4747 Lincoln Mall Dr Ste 100
Matteson, IL 60443-3812
Phone
(708) 747-8006
Fax
(708) 747-8272
NPI assigned
Mar 8, 2007
Last updated
Jul 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01051719 IN
Internal Medicine Physician 207R00000X 01051719 IN Primary

Addresses

Primary practice location

4747 Lincoln Mall Dr Ste 100
Matteson, IL 60443-3812

Mailing address

4747 Lincoln Mall Dr Ste 100
Matteson, IL 60443-3812
Phone (708) 747-8006

Other practice location 1

608 Chapel RD
Fort Wayne, IN 46845
Phone (260) 482-5091

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20160105002560 IN Practitioner - Emergency Medicine 5294710026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.02 of 100Reported as group
Quality
74.88
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01051719INMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Weight Management Center LLC. CurrentSince Aug 3, 2025 Accepting new patients
Community Hospital of Lagrange County Inc Current Accepting new patients
PHS Indian Hospital Past Accepting new patients

Locations

4747 Lincoln Mall Dr
Ste 100
Matteson, IL 60443
Phone (708) 747-8006

207 N Townline Rd
Lagrange, IN 46761
Phone (260) 266-5300

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.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784073600000",
    "number": "1114058617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4747 LINCOLN MALL DR STE 100",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604433812",
            "telephone_number": "708-747-8006",
            "fax_number": "708-747-8272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4747 LINCOLN MALL DR STE 100",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604433812",
            "telephone_number": "708-747-8006",
            "fax_number": "708-747-8272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "608 Chapel RD",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "46845",
            "country_code": "US",
            "telephone_number": "260-482-5091",
            "fax_number": "260-482-4442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLI-BALOGUN",
        "first_name": "SHERRIFF",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01051719",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01051719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Matteson, IL

Sources for this page

Verify at the official NPI Registry.