Individual provider Active NPI

Rafiya Hameeduddin, DO

  • Hospitalist Physician
  • Evanston, IL
National Provider Identifier
1245379320
Registry record updated Jan 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
036091808 Issued in IL
Practice address
2650 Ridge Ave.
Im Hospitalists Ste 4210
Evanston, IL 60201
Phone
(847) 570-1010
Fax
(847) 733-5108
NPI assigned
Feb 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 036091808 IL Primary
Internal Medicine Physician 207R00000X 036091808 IL

Addresses

Primary practice location

2650 Ridge Ave.
Im Hospitalists Ste 4210
Evanston, IL 60201

Mailing address

2650 Ridge Ave.
Im Hospitalists Ste 4210
Evanston, IL 60201
Phone (847) 570-1010

Other practice location 1

1 Kish Hospital Dr
Dekalb, IL 60115-9602
Phone (630) 607-8720

Other practice location 2

4309 W Medical Center Dr Ste A102
McHenry, IL 60050-8436
Phone (815) 759-4323

Other identifiers 5

IdentifierTypeStateIssuer
363149833OtherILTAX IDENTIFICATION NUMBER
3631498336019001OtherILCDPG HFS PAYEE ID
036091808MedicaidIL
0222075OtherILBLUE CROSS GROUP NUMBER
036091808OtherILSTATE LICENSE

Other names 1

  • Rafiya Khan Former name

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
I20050926000423 IL Practitioner - HospitalistPractitioner - Internal Medicine 6406880731 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

1 Kish Hospital Dr
Dekalb, IL 60115-9602
Phone (815) 766-7334

1800 N Main St
Wheaton, IL 60187-3112
Phone (630) 933-4800

300 Randall Rd
Geneva, IL 60134-4200
Phone (630) 933-4700

304 Randall Rd
Geneva, IL 60134-4200
Phone (630) 307-7799

5 Kish Hospital Dr
Dekalb, IL 60115-9602

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036091808ILMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Feb 1, 2017 Accepting new patients
Central Dupage Physician Group Internal Medicine CurrentSince Feb 1, 2020 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jul 1, 2022 Accepting new patients
Sound Physicians of Illinois, LLC Internal Medicine CurrentSince Nov 7, 2015 Accepting new patients
24 On Physicians, PC Hospitalist CurrentSince Dec 23, 2018 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jul 1, 2022 Accepting new patients
Endeavor Health Medical Group CurrentSince Jan 15, 2020 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Feb 1, 2017 Accepting new patients
Central Dupage Physician Group CurrentSince Feb 1, 2020 Accepting new patients
24 On Physicians, P.C. Hospitalist CurrentSince Dec 23, 2018 Accepting new patients
Endeavor Health Medical Group Internal Medicine CurrentSince Jan 15, 2020 Accepting new patients

Locations

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

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

Dept 5777
Carol Stream, IL 60122

9532 Eagle Way
Chicago, IL 60678

1044 N Francisco Ave
Chicago, IL 60622
Phone (773) 292-8227

29373 Network Pl
Chicago, IL 60673

1 Kish Hospital Dr
DeKalb, IL 60115
Phone (815) 754-1521

77 N Airlite St
Elgin, IL 60123
Phone (847) 622-3407

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

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

2650 Ridge Ave
Ste 4210
Evanston, IL 60201
Phone (847) 570-1010

1 Ingalls Dr
Harvey, IL 60426
Phone (708) 333-2300

11650 S State Route 47
Huntley, IL 60142
Phone (847) 802-7300

10400 Haligus Rd
Huntley, IL 60142
Phone (224) 654-0000

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

4309 W Medical Center Dr
Ste A102
McHenry, IL 60050
Phone (815) 759-4323

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

1300 Franklin Ave
Ste 380
Normal, IL 61761
Phone (309) 268-3589

1100 E Norris Dr
Ottawa, IL 61350
Phone (815) 416-1224

1600 W Walnut St
South Jacksonville, IL 62650
Phone (217) 245-7275

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Organizations & group practices 11

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 5

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1245379320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE.",
            "address_2": "IM HOSPITALISTS STE 4210",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "60201",
            "telephone_number": "847-570-1010",
            "fax_number": "847-733-5108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE.",
            "address_2": "IM HOSPITALISTS STE 4210",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "60201",
            "telephone_number": "847-570-1010",
            "fax_number": "847-733-5108"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Kish Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Dekalb",
            "state": "IL",
            "postal_code": "601159602",
            "country_code": "US",
            "telephone_number": "630-607-8720",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4309 W Medical Center Dr Ste A102",
            "address_purpose": "LOCATION",
            "city": "McHenry",
            "state": "IL",
            "postal_code": "600508436",
            "country_code": "US",
            "telephone_number": "815-759-4323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMEEDUDDIN",
        "first_name": "RAFIYA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036091808",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036091808",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION NUMBER",
            "identifier": "363149833",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPG HFS PAYEE ID",
            "identifier": "3631498336019001",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036091808",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GROUP NUMBER",
            "identifier": "0222075",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "036091808",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAFIYA",
            "last_name": "KHAN",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.