NPIMap

Individual provider Active NPI

Mohamed M.H. Al-Kazaz, M.D.

  • Cardiovascular Disease Physician
  • Chicago, IL
National Provider Identifier
1265795140
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036157829 Issued in IL
Practice address
676 N Saint Clair St Ste 600
Chicago, IL 60611-2981
Phone
(312) 664-3278
Fax
(312) 695-0063
NPI assigned
Jun 17, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 036157829 IL Primary
Cardiovascular Disease Physician 207RC0000X 292291 NY

Addresses

Primary practice location

676 N Saint Clair St Ste 600
Chicago, IL 60611-2981

Mailing address

676 N Saint Clair St Ste 600
Chicago, IL 60611-2981
Phone (312) 664-3278

Other practice location 1

1190 Fifth Avenue, GP1-Center
The Lauder Family Cardiovascular Ambulatory Center
New York, NY 10029-6574
Phone (855) 674-3278

Other practice location 2

234 E 85th St
New York, NY 10028-3001
Phone (212) 731-3420

Other practice location 3

1 Gustave L Levy Pl # 1030
New York, NY 10029-6504
Phone (212) 731-3420 ext. 3

Other practice location 4

1190 5th Ave # Gp-1West
New York, NY 10029-6503
Phone (212) 731-3420 ext. 3

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220120001702 IL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 9537412630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northwestern Medical Faculty Foundation 4,386 clinicians

Practice addresses (Care Compare)

676 N Saint Clair
Arkes 1725
Chicago, IL 60611-2927
Phone (312) 695-8108

Hospital & facility affiliations

  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Palos Community Hospital Hospital, Palos Heights, IL, CCN 140062
  • Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130
  • Northwestern Medicine Delnor Community Hospital Hospital, Geneva, IL, CCN 140211

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036157829ILMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Jan 1, 2022 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jan 1, 2022 Accepting new patients
Central Dupage Physician Group PastSince Feb 27, 2022 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

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

675 N Saint Clair St
Ste 19-100
Chicago, IL 60611
Phone (312) 664-3278

676 N Saint Clair St
Ste 1725
Chicago, IL 60611
Phone (312) 664-8533

676 N Saint Clair St
Ste 600
Chicago, IL 60611
Phone (312) 664-3278

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 7

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": "1339891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1265795140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST STE 600",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112981",
            "telephone_number": "312-664-3278",
            "fax_number": "312-695-0063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST STE 600",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112981",
            "telephone_number": "312-664-3278",
            "fax_number": "312-695-0063"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1190 Fifth Avenue, GP1-Center",
            "address_2": "The Lauder Family Cardiovascular Ambulatory Center",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100296574",
            "country_code": "US",
            "telephone_number": "855-674-3278",
            "fax_number": "212-410-7196",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "234 E 85th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100283001",
            "country_code": "US",
            "telephone_number": "212-731-3420",
            "fax_number": "212-360-7190",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Gustave L Levy Pl # 1030",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100296504",
            "country_code": "US",
            "telephone_number": "212-731-3420 x3",
            "fax_number": "212-731-3449",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1190 5th Ave # Gp-1West",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100296503",
            "country_code": "US",
            "telephone_number": "212-731-3420 x3",
            "fax_number": "212-731-3449",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AL-KAZAZ",
        "first_name": "MOHAMED",
        "middle_name": "M.H.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-17",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036157829",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "292291",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.