Individual provider Active NPI

Mohamed Zghouzi, MD

  • Interventional Cardiology Physician
  • Chicago, IL
National Provider Identifier
1275897993
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
036.166891 Issued in IL
Practice address
5841 S Maryland Ave
Chicago, IL 60637-1443
Phone
(773) 702-9461
Fax
(773) 702-4183
NPI assigned
Jun 27, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 4301502286 MI
Interventional Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0011X 036.166891 IL Primary
Internal Medicine Physician 207R00000X R73467 AZ
Student in an Organized Health Care Education/Training Program 390200000X TN

Addresses

Primary practice location

5841 S Maryland Ave
Chicago, IL 60637-1443

Mailing address

180 Harvester Dr Ste 110
Burr Ridge, IL 60527-4503
Phone (773) 702-1150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, IL, TN, KY4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20200723003770 MI Practitioner - Internal Medicine 6305153818 Reassigns benefits to 2 organizations
I20231103002263 IL Practitioner - Internal Medicine 6305153818 Reassigns benefits to 1 organization
I20240409001831 TN Practitioner - Internal Medicine 6305153818
I20240513003250 KY Practitioner - Internal Medicine 6305153818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
24 On Physicians PCGroup PAC ID 5698688141, 274 clinicians

Practice addresses (Care Compare)

217 S 3Rd St
Danville, KY 40422-1823
Phone (859) 239-5008

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R73467AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Specialty Services Multi-Specialty CurrentSince Jan 1, 2022 Accepting new patients
Trinity Medical Staffing LLC Multi-Specialty CurrentSince Dec 1, 2023 Accepting new patients
24 On Physicians, PC Multi-Specialty CurrentSince Mar 27, 2024 Accepting new patients
24 On Physicians, P.C. Multi-Specialty CurrentSince Mar 27, 2024 Accepting new patients
Inpatient Consultants of Michigan PC Multi-Specialty CurrentSince Oct 1, 2020 Accepting new patients
VHS Physicians of Michigan Multi-Specialty CurrentSince Jul 15, 2020 Accepting new patients
Ephraim McDowell Regional Medical Center Incorporated Past Accepting new patients

Locations

13000 Deerfield Pkwy
Ste 100
Alpharetta, GA 30004

2250 N Illinois Ave
Carbondale, IL 62901
Phone (618) 833-1691

100 Dr Warren Tuttle Dr
Harrisburg, IL 62946
Phone (618) 252-4956

217 S 3rd St
Danville, KY 40422
Phone (859) 239-1000

1014 E Grand River Ave
Brighton, MI 48116
Phone (810) 220-5222

1 William Carls Dr
Commerce Twp, MI 48382
Phone (248) 227-5500

3990 John R St
Detroit, MI 48201
Phone (313) 745-6211

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

4201 Saint Antoine St
Detroit, MI 48201
Phone (313) 745-3615

1500 E Sherman Blvd
Muskegon, MI 49444
Phone (231) 672-3027

Interoperability endpoints

  • Direct secure messaging: mohamed.zghouzi.1@7654.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1275897993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 HARVESTER DR STE 110",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605274503",
            "telephone_number": "773-702-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371443",
            "telephone_number": "773-702-9461",
            "fax_number": "773-702-4183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZGHOUZI",
        "first_name": "MOHAMED",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-27",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301502286",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IL",
            "license": "036.166891",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "R73467",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TN",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.