Individual provider Active NPI

Olufemi Kassim, M.D.

  • Gastroenterology Physician
  • Maywood, IL
National Provider Identifier
1174961999
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036140239 Issued in IL
Practice address
2160 S 1St Ave
Maywood, IL 60153-3328
Phone
(708) 216-9000
NPI assigned
Jun 14, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125063118 IL
Gastroenterology Physician 207RG0100X 280737 MA
Gastroenterology Physician 207RG0100X 036140239 IL Primary

Addresses

Primary practice location

2160 S 1St Ave
Maywood, IL 60153-3328

Mailing address

2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9000

Other practice location 1

5841 S Maryland Ave
MC 7082
Chicago, IL 60637-1447
Phone (773) 702-6840

Other practice location 2

5841 S Maryland Ave
MC 7082
Chicago, IL 60637-1447
Phone (773) 702-6840

Other practice location 3

830 Harrison Ave
Boston, MA 02118
Phone (617) 638-6525

Other practice location 4

4445 W Irving Park Rd Ste 200
Chicago, IL 60641-2808
Phone (312) 695-5620

Other names 1

  • Femi Kassim Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address okassim139760@direct.luhs.org Direct

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
I20210428002904 IL Practitioner - GastroenterologyPractitioner - Internal Medicine 8820391758 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4445 W Irving Park Rd
Suite 200
Chicago, IL 60641-2808
Phone (312) 644-3278

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy37
Upper gastrointestinal (GI) endoscopy for acid reflux42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
280737MAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Jan 1, 2024 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jan 1, 2024 Accepting new patients
Loyola University Medical Center Current Accepting new patients
Central Dupage Physician Group Internal Medicine Past Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

259 E Erie St
Ste 1600
Chicago, IL 60611

4445 W Irving Park Rd
#420
Chicago, IL 60641

5841 S Maryland Ave
Ste MC7082
Chicago, IL 60637
Phone (773) 702-6840

4445 W Irving Park Rd
Ste 200
Chicago, IL 60641
Phone (312) 664-3278

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

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": "1371168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1174961999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5841 S Maryland Ave",
            "address_2": "MC 7082",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606371447",
            "country_code": "US",
            "telephone_number": "773-702-6840",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5841 S Maryland Ave",
            "address_2": "MC 7082",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606371447",
            "country_code": "US",
            "telephone_number": "773-702-6840",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "830 Harrison Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "02118",
            "country_code": "US",
            "telephone_number": "617-638-6525",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4445 W Irving Park Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606412808",
            "country_code": "US",
            "telephone_number": "312-695-5620",
            "fax_number": "312-921-0403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KASSIM",
        "first_name": "OLUFEMI",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-14",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125063118",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MA",
            "license": "280737",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036140239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "okassim139760@direct.luhs.org",
            "affiliation": "N",
            "endpointDescription": "okassim139760@direct.luhs.org",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2160 S 1st Ave",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601533328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "FEMI",
            "last_name": "KASSIM",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.