Individual provider Active NPI

Roohi Urooj Wasiuddin, M.D

  • Pediatrics Physician
  • Chicago, IL
National Provider Identifier
1265629786
Registry record updated Nov 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
BP1-0023819 Issued in TX
Practice address
1431 N Western Ave
Suite 101
Chicago, IL 60622-1797
Phone
(773) 276-2272
NPI assigned
Sep 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2012

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 BP1-0023819 TX Primary

Addresses

Primary practice location

1431 N Western Ave
Suite 101
Chicago, IL 60622-1797

Mailing address

1775 S Fairfiled
Lombard, IL 60148
Phone (312) 520-6197

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
I20081203000152 IL Practitioner - Pediatric Medicine 6002977543 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP1-0023819TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Young H Mok P.C. Pediatrics Current Accepting new patients
Primecare Community Health, Inc. Current Accepting new patients
Primecare Community Health Inc CurrentSince Aug 25, 2020 Accepting new patients
Primecare Community Health, Inc. CurrentSince Aug 25, 2020 Accepting new patients
Primecare Community Health Inc Past Accepting new patients

Locations

1431 N Western Ave
Ste 406
Chicago, IL 60622
Phone (312) 491-5495

1431 N Western Ave
Chicago, IL 60622
Phone (312) 633-5866

1431 N Western Ave
Ste 101
Chicago, IL 60622
Phone (773) 276-2272

2211 N Elston Ave
Ste 301
Chicago, IL 60614

1431 N Western Ave
Ste 209
Chicago, IL 60622
Phone (312) 491-5435

1431 N Western Ave
Ste 202
Chicago, IL 60622
Phone (773) 276-2272

1920 N Hamlin Ave
Chicago, IL 60647
Phone (773) 772-7202

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": "1190937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351728000000",
    "number": "1265629786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 S FAIRFILED",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "60148",
            "telephone_number": "312-520-6197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 N WESTERN AVE",
            "address_2": "SUITE 101",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221797",
            "telephone_number": "773-276-2272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASIUDDIN",
        "first_name": "ROOHI",
        "middle_name": "UROOJ",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-28",
        "last_updated": "2012-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "BP1-0023819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.