Individual provider Active NPI

Aisha Y Qidwae, MSN, NP-C

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1205313723
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209017982 Issued in IL
Practice address
779 W Adams St
Chicago, IL 60661-3509
Phone
(312) 382-8308
NPI assigned
Jul 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209017982 IL Primary
Family Nurse Practitioner 363LF0000X 95009399 CA

Addresses

Primary practice location

779 W Adams St
Chicago, IL 60661-3509

Mailing address

779 W Adams St
Chicago, IL 60661-3509
Phone (312) 382-8308

Other practice location 1

425 California St Ste 1400
San Francisco, CA 94104-2116
Phone (831) 484-7713

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181002001041 IL Practitioner - Nurse Practitioner 7911258991 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Express Care 2, IncGroup PAC ID 0547495467, 221 clinicians

Practice addresses (Care Compare)

40 75TH St
Willowbrook, IL 60527-2325
Phone (630) 581-5372

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95009399CAMDFamily Nurse Practitioner
95028752CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
California Mobile Medical Group Inc CurrentSince Nov 19, 2023 Accepting new patients
Midwest Express Care 2, Inc CurrentSince Sep 15, 2025 Accepting new patients
Midwest Express Care 2, Inc CurrentSince Sep 15, 2025 Accepting new patients
Endeavor Health Medical Group CurrentSince Sep 12, 2018 Accepting new patients
Endeavor Health Medical Group CurrentSince Sep 12, 2018 Accepting new patients

Locations

130 N Brand Blvd
Ste 208
Glendale, CA 91203
Phone (818) 945-6003

9532 Eagle Way
Chicago, IL 60678

779 W Adams St
Chicago, IL 60661
Phone (312) 382-8308

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

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

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

40 75th St
Willowbrook, IL 60527
Phone (630) 326-5312

Organizations & group practices 5

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": "1532563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1205313723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "779 W ADAMS ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606613509",
            "telephone_number": "312-382-8308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "779 W ADAMS ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606613509",
            "telephone_number": "312-382-8308"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "425 California St Ste 1400",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941042116",
            "country_code": "US",
            "telephone_number": "831-484-7713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QIDWAE",
        "first_name": "AISHA",
        "middle_name": "Y",
        "credential": "MSN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-26",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209017982",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95009399",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.