Ismam Islam

Primary specialty

Genetic Counselor (M.S.)Taxonomy code 170300000X

License

246-000717 Issued in IL

Practice address

900 W Nelson St
Chicago, IL 60657-6704

Phone

(773) 296-5351

NPI assigned

Jun 14, 2019

Last updated

Nov 25, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: iislam348473@direct.myadvocateaurora.org

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

{
    "created_epoch": "1560470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1346800158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W NELSON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606576704",
            "telephone_number": "773-296-5351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "615 S New Ballas Rd Ste G400",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631418221",
            "country_code": "US",
            "telephone_number": "314-251-6884",
            "fax_number": "314-251-4157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISLAM",
        "first_name": "ISMAM",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-14",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "IL",
            "license": "246-000717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "900 W Nelson St",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606576704",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "iislam348473@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "900 W Nelson St",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606576704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anastasia Iskow, BCBA, LPC
• Iskra Therapy & Consulting LLC
• Annette Iskra, LCSW
• Ahsana Anjum Islam, DPM
• Alimul Islam, MD
• Nadia Islam
• Rafya Nuzhat Islam
• Sundis I Islefo, PHARMACIST
• Ismaeil Najjar DMD PC (SmileWell Dentistry)
• Hala Ismail, FNP

• Genetic Counselor (M.S.) in Chicago, IL
• Providers in Chicago, IL by specialty
• Genetic Counselor (M.S.) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; 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.