Organization Active NPI

Nasreen Hamidani Internal Medicine PLLC

  • Internal Medicine Physician
  • Riverside, IL
National Provider Identifier
1215670229
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
NASREEN HAMIDANI INTERNAL MEDICINE PLLC
Practice address
2910 Harlem Ave
Riverside, IL 60546-1785
Phone
(630) 935-3770
NPI assigned
Apr 18, 2022
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Nasreen Hamidani, MDNPI 1851483812
Title
Owner
Phone
(630) 935-3770

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20220519002503 IL Part B Supplier - Clinic/Group Practice 0446637003 Receives reassigned benefits from 1 practitioner
Practice locations: Riverside, IL

National Provider Directory

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

2910 Harlem Ave
Riverside, IL 60546-1785

Mailing address

431 S Edgewood Ave
Wood Dale, IL 60191-2515

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 22, 2024.

{
    "created_epoch": "1650240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732233600000",
    "number": "1215670229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 S EDGEWOOD AVE",
            "city": "WOOD DALE",
            "state": "IL",
            "postal_code": "601912515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 HARLEM AVE",
            "city": "RIVERSIDE",
            "state": "IL",
            "postal_code": "605461785",
            "telephone_number": "630-935-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NASREEN HAMIDANI INTERNAL MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-18",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A",
        "authorized_official_last_name": "HAMIDANI",
        "authorized_official_first_name": "NASREEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-935-3770",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.