NPIMap

Individual provider Active NPI

Farooq Masood Ahmed, M.D

  • Geriatric Medicine (Family Medicine) Physician
  • Skokie, IL
National Provider Identifier
1275553240
Registry record updated Nov 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
036118695 Issued in IL
Practice address
5200 Main St Ste 201
Family Practice/Dept of Geriatrics
Skokie, IL 60077-2100
Phone
(312) 423-7869
NPI assigned
Jul 20, 2006
Last updated
Nov 22, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Family Medicine) Physician 207QA0000X 01062175A IN
Geriatric Medicine (Family Medicine) Physician 207QG0300X 036118695 IL Primary

Addresses

Primary practice location

5200 Main St Ste 201
Family Practice/Dept of Geriatrics
Skokie, IL 60077-2100

Mailing address

2600 S Michigan Ave
308
Chicago, IL 60616-2857
Phone (312) 810-7786

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
I20071103000117 IL Practitioner - Family PracticePractitioner - Geriatric Medicine 7719089127 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Medical Group LTDGroup PAC ID 1153585658, 7 clinicians

Practice addresses (Care Compare)

2600 S Michigan Ave
Suite 308
Chicago, IL 60616-0049
Phone (312) 326-6666

4419 W 95TH St
Oak Lawn, IL 60453-7223
Phone (708) 576-4700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01062175AINMDAdolescent Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Group LTD CurrentSince Dec 29, 2011 Accepting new patients
Faminamed Healthcare Providers SC Geriatric Medicine CurrentSince Apr 30, 2003 Accepting new patients
Medici Healthcare Providers S.C Past Accepting new patients
Faminamed Healthcare Providers S.C Past Accepting new patients
M & F Medical Services, LTD Past Accepting new patients
Mobile Physicians Inc PastSince Sep 1, 2007 Accepting new patients
Lakeside Medical Group LTD PastSince May 1, 2007 Accepting new patients

Locations

2600 S Michigan Ave
Ste 308
Chicago, IL 60616
Phone (312) 423-7869

Organizations & group practices 7

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.

Hospital & facility affiliations 8

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385078400000",
    "number": "1275553240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 S MICHIGAN AVE",
            "address_2": "308",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162857",
            "telephone_number": "312-810-7786",
            "fax_number": "847-673-0292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 MAIN ST STE 201",
            "address_2": "FAMILY PRACTICE/DEPT OF GERIATRICS",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600772100",
            "telephone_number": "312-423-7869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "FAROOQ",
        "middle_name": "MASOOD",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2013-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0000X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "IN",
            "license": "01062175A",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "036118695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.