Individual provider Active NPI

Mohammed Jawad Ali, MD

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1164552055
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036062868 Issued in IL
Practice address
732 South Pulaski Road
Chicago, IL 60624
Phone
(773) 533-1621
Fax
(773) 533-1622
NPI assigned
Mar 7, 2007
Sex
Male
Sole proprietor
No

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 036062868 IL Primary

Addresses

Primary practice location

732 South Pulaski Road
Chicago, IL 60624

Mailing address

211 Somerset Road
Willowbrook, IL 60527
Phone (630) 323-9504

Other identifiers 1

IdentifierTypeStateIssuer
036062868MedicaidIL

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
I20100319000125 IL Practitioner - Internal MedicinePractitioner - General PracticePractitioner - Family Practice 2264567916 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Family Practice, General Practice
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

732 S Pulaski Rd
Chicago, IL 60624-4058
Phone (773) 533-1621

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Jfa Medical Group SC CurrentSince Aug 1, 2002 Accepting new patients
Carepeople,Inc Past Accepting new patients

Locations

732 S Pulaski Rd
Chicago, IL 60624
Phone (773) 533-1621

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164552055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 SOMERSET ROAD",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "60527",
            "telephone_number": "630-323-9504",
            "fax_number": "773-533-1622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "732 SOUTH PULASKI ROAD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60624",
            "telephone_number": "773-533-1621",
            "fax_number": "773-533-1622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALI",
        "first_name": "MOHAMMED",
        "middle_name": "JAWAD",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036062868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036062868",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.