Individual provider Active NPI

Ahmer V Farooq, D.O.

  • Urology Physician
  • Maywood, IL
National Provider Identifier
1326201666
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
036122015 Issued in IL
Practice address
2160 S 1St Ave
Department of Urology, Fahey Center RM 260
Maywood, IL 60153-3328
Phone
(708) 216-5100
Fax
(708) 216-8991
NPI assigned
Jul 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 036122015 IL Primary

Addresses

Primary practice location

2160 S 1St Ave
Department of Urology, Fahey Center RM 260
Maywood, IL 60153-3328

Mailing address

2160 S 1St Ave
Department of Urology, Fahey Center RM 239a
Maywood, IL 60153-3328
Phone (708) 216-5100

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address afarooq29772@direct.luhs.org Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 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
I20110915000722 IL Practitioner - Urology 3375714728 Reassigns benefits to 2 organizations
I20240823001650 IN Practitioner - Urology 3375714728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Loyola University Medical CenterGroup PAC ID 3779488903, 917 clinicians

Practice addresses (Care Compare)

2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9000

611 E Douglas Rd
Suite 203
Mishawaka, IN 46545-1467
Phone (574) 335-6830

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection30
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center CurrentSince Sep 1, 2011 Accepting new patients
Loyola Medical Group LLC CurrentSince Sep 1, 2020 Accepting new patients
Loyola University Medical Center Current Accepting new patients
Saint Joseph Regional Medical Center, Inc. CurrentSince Aug 15, 2024 Accepting new patients
Loyola University Medical Center CurrentSince Sep 1, 2011 Accepting new patients
Saint Joseph Regional Medical Center, Inc. Urology CurrentSince Aug 15, 2024 Accepting new patients

Locations

3231 Euclid Ave
Ste 403
Berwyn, IL 60402
Phone (708) 783-0700

3231 Euclid Ave
Ste 407
Berwyn, IL 60402
Phone (708) 783-7430

6800 N Frontage Rd
Burr Ridge, IL 60527
Phone (708) 327-1000

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

2160 S 1st Ave
Rm 239A
Maywood, IL 60153

2160 S 1st Ave
Rm 260
Maywood, IL 60153
Phone (708) 216-5100

611 E Douglas Rd
Ste 309
Mishawaka, IN 46545
Phone (574) 335-6232

5215 Holy Cross Pkwy
Mishawaka, IN 46545
Phone (574) 335-2443

611 E Douglas Rd
Ste 203
Mishawaka, IN 46545
Phone (574) 335-6640

616 E 13th St
Winamac, IN 46996
Phone (574) 946-2100

Interoperability endpoints

  • Direct secure messaging: afarooq3805670@direct.trinity-health.org

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1326201666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "address_2": "DEPARTMENT OF UROLOGY, FAHEY CENTER RM 239A",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-5100",
            "fax_number": "708-216-8991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "address_2": "DEPARTMENT OF UROLOGY, FAHEY CENTER RM 260",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-5100",
            "fax_number": "708-216-8991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAROOQ",
        "first_name": "AHMER",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-07",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "036122015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "afarooq29772@direct.luhs.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2160 S 1st Ave",
            "address_2": "Department of Urology, Fahey Center Rm 260",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601533328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.