Individual provider Active NPI

Ayman Pharaon, MD

  • Pediatrics Physician
  • Willowbrook, IL
National Provider Identifier
1275049066
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
C200576 Issued in CA
Practice address
7275 Willow Way LN Unit 4D
Willowbrook, IL 60527-7520
Phone
(434) 409-0552
NPI assigned
Dec 16, 2017
Last updated
Jul 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036.062886 IL
Pediatrics Physician 208000000X C200576 CA Primary
General Practice Physician 208D00000X 036.062886 IL

Addresses

Primary practice location

7275 Willow Way LN Unit 4D
Willowbrook, IL 60527-7520

Mailing address

7275 Willow Way LN Unit 4D
Willowbrook, IL 60527-7520
Phone (434) 409-0552

Other identifiers 1

IdentifierTypeStateIssuer
036.062886OtherILMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220114000640 IL Practitioner - Pediatric Medicine 0648662023 Reassigns benefits to 1 organization
I20250813004016 CA Practitioner - Pediatric MedicinePractitioner - General Practice 0648662023 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: General Practice
Education
Other, 1976
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

300 N San Antonio Rd
Santa Barbara, CA 93110-1316

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C200576CAMDPediatrics Physician
036.062886ILMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Barbara County Auditor CurrentSince Jul 25, 2025 Accepting new patients
Santa Barbara County Auditor Current Accepting new patients
Cook County Current Accepting new patients
Santa Barbara County Auditor CurrentSince Jul 25, 2025 Accepting new patients
Cook County Pediatrics CurrentSince Feb 15, 2024 Accepting new patients
Cook County CurrentSince Feb 15, 2024 Accepting new patients

Locations

300 N San Antonio Rd
Santa Barbara, CA 93110
Phone (805) 681-5220

300 N San Antonio Rd
Rm 107
Santa Barbara, CA 93110
Phone (805) 681-5461

2115 Centerpointe Pkwy
Santa Maria, CA 93455
Phone (805) 346-7230

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1513382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1275049066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7275 WILLOW WAY LN UNIT 4D",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605277520",
            "telephone_number": "434-409-0552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7275 WILLOW WAY LN UNIT 4D",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605277520",
            "telephone_number": "434-409-0552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHARAON",
        "first_name": "AYMAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-16",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036.062886",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "C200576",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "036.062886",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "036.062886",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willowbrook, IL

Sources for this page

Verify at the official NPI Registry.