Anjum Hameeduddin, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036051648 Issued in IL

Practice address

4647 Lincoln Hwy
Matteson, IL 60443-2319

Phone

(708) 747-7720

Fax

(708) 915-7239

NPI assigned

Jul 19, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Cressa Perish MD SC

  • Family Medicine Physician
  • Flossmoor, IL
  • NPI 1467553743
  NPD (past)

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361318400000",
    "number": "1285633461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1119",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604434119",
            "telephone_number": "708-747-5850",
            "fax_number": "708-747-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4647 LINCOLN HWY",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604432319",
            "telephone_number": "708-747-7720",
            "fax_number": "708-915-7239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMEEDUDDIN",
        "first_name": "ANJUM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-19",
        "last_updated": "2013-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036051648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036051648",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leigh James Griffith, PT,CMP
• Jessica Griggs
• Caitlin Grimwood
• Demetria Guider
• Sharon Gunn, P.T.
• Alyssa Hamilton
• Mark Harris, LCSW
• Mikkal Harris, LCPC
• Derrick Lawrence Hassert, PH.D.
• Tinica Hautman

• Family Medicine Physician in Matteson, IL
• Providers in Matteson, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.