Individual provider Active NPI

Shoeb Mohammed Hussain, MD

  • Advanced Heart Failure and Transplant Cardiology Physician
  • Park Ridge, IL
National Provider Identifier
1184990673
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Heart Failure and Transplant Cardiology PhysicianTaxonomy code 207RA0001X
License
036137715 Issued in IL
Practice address
1875 Dempster St Ste 555
Park Ridge, IL 60068-1188
Phone
(847) 698-5500
Fax
(847) 698-5517
NPI assigned
Mar 28, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 036137715 IL
Advanced Heart Failure and Transplant Cardiology Physician 207RA0001X 036137715 IL Primary

Addresses

Primary practice location

1875 Dempster St Ste 555
Park Ridge, IL 60068-1188

Mailing address

29373 Network PL
Chicago, IL 60673-3328
Phone (847) 390-5900

Other names 1

  • Mohammed Shoeb Hussain Tareq Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address shussain229716@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
I20190614000303 IL Practitioner - Cardiovascular Disease (Cardiology) 4284930850 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advocate Health and Hospitals CorporationGroup PAC ID 7810800935, 3,081 clinicians

Practice addresses (Care Compare)

10 N Cumberland Ave
Park Ridge, IL 60068-3215
Phone (847) 825-0300

1775 Ballard Rd
Park Ridge, IL 60068-1005
Phone (847) 318-9368

1775 Dempster St
Park Ridge, IL 60068-1143

1775 W Ballard Rd
Geriatrics
Park Ridge, IL 60068-1005
Phone (847) 318-2500

1875 Dempster St
Park Ridge, IL 60068-1186

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

77 Rand Rd
Des Plaines, IL 60016-1005
Phone (847) 294-5490

Hospital & facility affiliations

  • Advocate Lutheran General Hospital Hospital, Park Ridge, IL, CCN 140223
  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036137715ILMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jul 12, 2019 Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Jul 12, 2019 Accepting new patients

Locations

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

836 W Wellington Ave
Chicago, IL 60657
Phone (773) 296-7054

29373 Network Pl
Chicago, IL 60673

1875 W Dempster St
Ste 555
Park Ridge, IL 60068
Phone (847) 698-5500

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": "1332892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1184990673",
    "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": "606733328",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 DEMPSTER ST STE 555",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681188",
            "telephone_number": "847-698-5500",
            "fax_number": "847-698-5517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSSAIN",
        "first_name": "SHOEB",
        "middle_name": "MOHAMMED",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-28",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036137715",
            "primary": false
        },
        {
            "code": "207RA0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Advanced Heart Failure and Transplant Cardiology",
            "state": "IL",
            "license": "036137715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shussain229716@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1875 Dempster St Ste 555",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681188",
            "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": "1875 Dempster St Ste 555",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MOHAMMED",
            "last_name": "HUSSAIN TAREQ",
            "middle_name": "SHOEB",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.