Mohammad Adnan, MD
Individual provider Active NPI Neonatal-Perinatal Medicine Physician · Chicago, IL
NPI 1306239918 · NPPES record last updated Jul 20, 2023
Key facts
- NPI
- 1306239918
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Neonatal-Perinatal Medicine Physician 2080N0001X
- License
- C186470 (CA)
- Practice address
- 1901 W Harrison St
Division of Neonatology
Chicago, IL 60612-3714 - Phone
- (312) 864-4044
- NPI assigned
- Mar 7, 2015
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180614001051 | IN | Practitioner - Pediatric Medicine | 0749578896 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01079643A | IN | MD | Pediatrics Physician |
| C186470 | CA | MD | Neonatal-Perinatal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Indiana University Health Ball Memorial Physicians, Inc. | Multi-Specialty | Current |
Accepting new patients |
| Indiana University Health Ball Memorial Physicians, Inc. | Multi-Specialty | Current |
Accepting new patients |
| Union Hospital Inc. | Current | Accepting new patients | |
| Pediatrix Medical Group of California, a Professional Corporation | Multi-Specialty | Past | Accepting new patients |
Locations
3832 Solutions Ctr
Chicago, IL 60677
250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174
2401 W University Ave
Muncie, IN 47303
Phone (765) 747-3111
221 N Celia Ave
Muncie, IN 47303
Phone (765) 747-3141
1200 W White River Blvd
Muncie, IN 47303
Phone (765) 254-4009
Interoperability endpoints
- madnan@unionhealth.cernerdirect.com
- madnan797106@direct.memorialcare.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician |
208000000X | 01079643A | IN | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Neonatal-Perinatal Medicine Physician | 2080N0001X | C186470 | CA | Yes |
Addresses
Primary practice location
1901 W Harrison St
Division of Neonatology
Chicago, IL 60612-3714
Mailing address
1200 W. White River Blvd.
RCS Provider Enrollment
Muncie, IN 47303-4988
Phone (765) 254-4009
Other providers in Chicago, IL
- Brian Adley
- Mahmoud Adly
- Admiral at the Lake
- Admiral Home Health Inc.
- Adnan Lab Inc
- Scott Kellam Adney
- Emily G Adochio-Clancy
- Bola Adojutelegan
- Adolescent and Young Adult Place LTD
- Emem Inyang Adolf-Ubokudom
All providers in Chicago, IL · Neonatal-Perinatal Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 20, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.