Individual provider Active NPI

Solomon M Yigazu, MD

  • Family Medicine Physician
  • Lincolnwood, IL
National Provider Identifier
1376539221
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036109667 Issued in IL
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

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041008000177 IL Practitioner - Family PracticePractitioner - Emergency Medicine 9830158492

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036109667ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.