Active NPI
Solomon M Yigazu, MD
- Family Medicine Physician
- Lincolnwood, IL
National Provider Identifier
1376539221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036109667
- Practice address
- 7126 N Lincoln Ave
Lincolnwood, IL 60712-2234 - Phone
- (847) 583-9189
- Fax
- (847) 583-9196
- NPI assigned
- Sep 26, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036109667 | IL | Primary |
Addresses
Primary practice location
7126 N Lincoln Ave
Lincolnwood, IL 60712-2234
Mailing address
3660 N Lake Shore Dr
1807
Chicago, IL 60613-5300
Phone (312) 560-1996
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041008000177 | IL | Practitioner - Family Practice | 9830158492 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036109667 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Concentra Primary Care of Illinois PC | Past | Accepting new patients | |
| Spinal Rehabilitation and Wellness Clinic, LLC | Family Medicine | Past | Accepting new patients |
| Neck to Back Rockford LLC | Family Medicine | Past | Accepting new patients |
| Sullivan Urgent Aid Centers, LTD | Past | Accepting new patients |
Organizations & group practices 4
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.
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- NPI 1376789545
-
- Emergency Medicine Physician
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- NPI 1235175803
-
- Primary Care Clinic/Center
- Addison, TX
- NPI 1811267396
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376539221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3660 N LAKE SHORE DR",
"address_2": "1807",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606135300",
"telephone_number": "312-560-1996",
"fax_number": "312-247-2267"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7126 N LINCOLN AVE",
"city": "LINCOLNWOOD",
"state": "IL",
"postal_code": "607122234",
"telephone_number": "847-583-9189",
"fax_number": "847-583-9196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YIGAZU",
"first_name": "SOLOMON",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036109667",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lincolnwood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.