Individual provider Active NPI

Syeda Shariff, M.D.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1205935277
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036061665 Issued in IL
Practice address
1276 N Clybourn Ave
Chicago, IL 60610-2089
Phone
(312) 337-1073
Fax
(312) 337-7616
NPI assigned
Sep 22, 2006
Sex
Female
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
Family Medicine Physician 207Q00000X 036061665 IL Primary

Addresses

Primary practice location

1276 N Clybourn Ave
Chicago, IL 60610-2089

Mailing address

1276 N Clybourn Ave
Chicago, IL 60610-2089
Phone (312) 337-1073

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
I20150211000739 IL Practitioner - Family Practice 6608191820 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Near North Health Service Corporation Current Accepting new patients
Near North Health Service Corporation CurrentSince Jan 1, 2012 Accepting new patients
Near North Health Service Corporation CurrentSince Jan 1, 2012 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

4259 S Berkeley Ave
Chicago, IL 60653
Phone (773) 268-7600

150 E Huron St
Chicago, IL 60611
Phone (312) 640-2473

800 N Kedzie Ave
Chicago, IL 60651
Phone (773) 722-8202

1276 N Clybourn Ave
Chicago, IL 60610
Phone (312) 337-1073

1520 N Kostner Ave
Chicago, IL 60651
Phone (312) 216-8020

Interoperability endpoints

  • Direct secure messaging: syeda.shariff.1@31131.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205935277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 N CLYBOURN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606102089",
            "telephone_number": "312-337-1073",
            "fax_number": "312-337-7616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276 N CLYBOURN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606102089",
            "telephone_number": "312-337-1073",
            "fax_number": "312-337-7616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARIFF",
        "first_name": "SYEDA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036061665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.