Individual provider Active NPI

Ahmad Nourallah, MD

  • Surgery Physician
  • Naperville, IL
National Provider Identifier
1164965992
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
036-160922 Issued in IL
Practice address
1948 Three Farms Ave
Naperville, IL 60540-1105
Phone
(630) 355-5633
Fax
(630) 355-5215
NPI assigned
Nov 28, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 036-160922 IL Primary

Addresses

Primary practice location

1948 Three Farms Ave
Naperville, IL 60540-1105

Mailing address

1948 Three Farms Ave
Naperville, IL 60540-1105
Phone (630) 355-5633

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
I20220811003640 IL Practitioner - General Surgery 7911288014 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

1 E County Line Rd
Sandwich, IL 60548-2178
Phone (815) 786-2722

1948 Three Farms Ave
Naperville, IL 60540-1105
Phone (630) 355-5668

24600 W 127TH St
Plainfield, IL 60585-9507

2650 Ridge Ave
Evanston, IL 60201-1700

76 W Countryside Pkwy
Yorkville, IL 60560-1967
Phone (630) 553-2722

801 S Washington St
Naperville, IL 60540-7430
Phone (630) 527-5197

Hospital & facility affiliations

  • Edward Hospital Hospital, Naperville, IL, CCN 140231

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)20
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-160922ILMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Nov 1, 2023 Accepting new patients
Edward Health Ventures CurrentSince Aug 1, 2022 Accepting new patients
Endeavor Health Medical Group CurrentSince Nov 1, 2023 Accepting new patients
Edward Health Ventures CurrentSince Aug 1, 2022 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

120 Spalding Dr
Ste 310
Naperville, IL 60540
Phone (630) 527-5575

120 Spalding Dr
Naperville, IL 60540
Phone (630) 527-5575

1948 Three Farms Ave
Naperville, IL 60540
Phone (630) 355-5633

120 Spalding Dr
Ste 101
Naperville, IL 60540
Phone (630) 527-7730

24600 W 127th St
Ste B215
Plainfield, IL 60585
Phone (630) 355-5688

1 E County Line Rd
Sandwich, IL 60548
Phone (815) 786-2722

Interoperability endpoints

  • Direct secure messaging: anouraillah250783@direct.edward.org

Organizations & group practices 4

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 1

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": "1480291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1164965992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1948 THREE FARMS AVE",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605401105",
            "telephone_number": "630-355-5633",
            "fax_number": "630-355-5215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1948 THREE FARMS AVE",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605401105",
            "telephone_number": "630-355-5633",
            "fax_number": "630-355-5215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOURALLAH",
        "first_name": "AHMAD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-28",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036-160922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.