Individual provider Active NPI

Reema Mohammed, M.D.

  • Pediatrics Physician
  • Berwyn, IL
National Provider Identifier
1255596805
Registry record updated Feb 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036130447 Issued in IL
Practice address
3340 Oak Park Ave Ste 201
Berwyn, IL 60402-3483
Phone
(708) 795-5502
NPI assigned
Jul 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036130447 IL Primary

Addresses

Primary practice location

3340 Oak Park Ave Ste 201
Berwyn, IL 60402-3483

Mailing address

3340 Oak Park Ave Ste 201
Berwyn, IL 60402-3483
Phone (815) 838-7337

Other identifiers 1

IdentifierTypeStateIssuer
036130447MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036130447ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Care Pediatrics Inc Pediatrics Current Accepting new patients
Care Pediatrics LLC Pediatrics Current Accepting new patients
Advanced Pediatric Care, LTD. Pediatrics Past Accepting new patients

Locations

3340 Oak Park Ave
Ste 201
Berwyn, IL 60402
Phone (708) 788-6400

41 W Roosevelt Rd
Villa Park, IL 60181

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/f99feffa-a04a-4042-9325-6ec22532618b/

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.

NPI Registry JSON

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1255596805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 OAK PARK AVE STE 201",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023483",
            "telephone_number": "815-838-7337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 OAK PARK AVE STE 201",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023483",
            "telephone_number": "708-795-5502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMMED",
        "first_name": "REEMA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-23",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036130447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036130447",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.