NPIMap

Individual provider Active NPI

Ashir Wahab, MD

  • Family Medicine Physician
  • Lynwood, IL
National Provider Identifier
1376591958
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036096993 Issued in IL
Practice address
19400 North Creek Drive
Lynwood, IL 60411-8742
Phone
(708) 474-0410
Fax
(708) 474-0328
NPI assigned
May 5, 2006
Last updated
Nov 18, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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 036096993 IL Primary

Addresses

Primary practice location

19400 North Creek Drive
Lynwood, IL 60411-8742

Mailing address

PO Box 639295 Dept 93394
Cincinnati, OH 45263-9295
Phone (248) 434-6169

Other practice location 1

1000 Burr Ridge Pkwy Ste 201
Burr Ridge, IL 60527-0864
Phone (312) 818-4650

Other identifiers 2

IdentifierTypeStateIssuer
036096993MedicaidIL
080188117OtherILMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100520001014 IN Practitioner - Family Practice 2062303274 Reassigns benefits to 1 organization
I20100610000060 IL Practitioner - Family Practice 2062303274 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Curana Health of Illinois PCGroup PAC ID 1456724434, 35 clinicians
CH Specialty Services Il PLLCGroup PAC ID 8224402482, 20 clinicians

Practice addresses (Care Compare)

111 W Jackson Blvd
Suite 1700
Chicago, IL 60604-3597
Phone (337) 991-9276

1207 Vandalia St
Collinsville, IL 62234-4092
Phone (337) 991-9276

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036096993ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CH MSSP Services TN PLLC CurrentSince Oct 4, 2023 Accepting new patients
Vpa PC Family Medicine Current Accepting new patients
Hansa Medical Groupe PLLC CurrentSince May 1, 2018 Accepting new patients
Vpa PC Family Medicine CurrentSince Oct 18, 2022 Accepting new patients
Curana Health of Illinois PC CurrentSince Oct 4, 2023 Accepting new patients
Vpa PC Family Medicine CurrentSince Oct 18, 2022 Accepting new patients

Locations

1000 Burr Ridge Pkwy
Ste 201
Burr Ridge, IL 60527
Phone (312) 818-4650

111 W Jackson Blvd
Ste 1700
Chicago, IL 60604
Phone (708) 223-8405

7108 Marine Rd
Edwardsville, IL 62025
Phone (618) 706-9759

1509 Dulles Dr
Lafayette, LA 70506
Phone (337) 408-0803

5750 Johnston St
Ste 205
Lafayette, LA 70503
Phone (337) 580-3330

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668729600000",
    "number": "1376591958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639295 DEPT 93394",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452639295",
            "telephone_number": "248-434-6169",
            "fax_number": "855-618-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19400 NORTH CREEK DRIVE",
            "city": "LYNWOOD",
            "state": "IL",
            "postal_code": "604118742",
            "telephone_number": "708-474-0410",
            "fax_number": "708-474-0328"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Burr Ridge Pkwy Ste 201",
            "address_purpose": "LOCATION",
            "city": "Burr Ridge",
            "state": "IL",
            "postal_code": "605270864",
            "country_code": "US",
            "telephone_number": "312-818-4650",
            "fax_number": "855-618-2629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAHAB",
        "first_name": "ASHIR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036096993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036096993",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "080188117",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynwood, IL

Sources for this page

Verify at the official NPI Registry.