Individual provider Active NPI

Lina Jamal Abdallah Ghazal, MD

  • Internal Medicine Physician
  • South Holland, IL
National Provider Identifier
1164050050
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-165467 Issued in IL
Practice address
100 W 162ND St
South Holland, IL 60473-2003
Phone
(708) 730-2200
NPI assigned
Mar 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125.076526 IL
Internal Medicine Physician 207R00000X 036-165467 IL Primary

Addresses

Primary practice location

100 W 162ND St
South Holland, IL 60473-2003

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Other practice location 1

2525 S Michigan Ave
Chicago, IL 60616-2332
Phone (312) 567-2000

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ljamalabdallahghazal380826@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20230905002008 IL Practitioner - Internal Medicine 3072901610 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advocate Health and Hospitals Corporation 3,081 clinicians

Practice addresses (Care Compare)

17800 Kedzie Ave
Hazel Crest, IL 60429-2029
Phone (708) 684-5340

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

Hospital & facility affiliations

  • Advocate Trinity Hospital Hospital, Chicago, IL, CCN 140048

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-165467ILMDInternal Medicine Physician
125.076526ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Aug 11, 2023 Accepting new patients
Loyola University Medical Center Current Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Aug 11, 2023 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

100 W 162nd St
South Holland, IL 60473
Phone (708) 730-2200

Interoperability endpoints

  • Direct secure messaging: ljamalabdallahghazal380826@direct.myadvocateaurora.org
  • Direct secure messaging: ljamalabdallahghazal130618@direct.luhs.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 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": "1585353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1164050050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W 162ND ST",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604732003",
            "telephone_number": "708-730-2200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2525 S Michigan Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606162332",
            "country_code": "US",
            "telephone_number": "312-567-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAMAL ABDALLAH GHAZAL",
        "first_name": "LINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-28",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.076526",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-165467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ljamalabdallahghazal380826@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "100 W 162nd St",
            "city": "South Holland",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604732003",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "100 W 162nd St",
            "city": "South Holland",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604732003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in South Holland, IL

Sources for this page

Verify at the official NPI Registry.