Mahnaz Jeelani Ali, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036.123445 Issued in IL

Practice address

1111 Superior St
Suite 207
Melrose Park, IL 60160-4138

Phone

(708) 406-3040

Fax

(708) 406-3053

NPI assigned

Aug 6, 2007

Last updated

Dec 30, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Family Practice

Education

Midwestern University, Chicago College of Osteopathic Med, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

PCC Community Wellness CenterGroup PAC ID 1557270139, 91 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mahnaz.ali.1@13158.direct.athenahealth.com

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.

• PCC Community Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Oak Park, IL
  • NPI 1871516799
  Medicare reassignment Care Compare group NPD
• PCC Community Wellness Center

  dba PCC Austin Dental & Specialty Care Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1134954506
  NPD
• PCC Community Wellness Center

  dba PCC Austin Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1609892223
  NPD (past)

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577664000000",
    "number": "1376734202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 SUPERIOR ST",
            "address_2": "SUITE 207",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601604138",
            "telephone_number": "708-406-3040",
            "fax_number": "708-406-3053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 SUPERIOR ST",
            "address_2": "SUITE 207",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601604138",
            "telephone_number": "708-406-3040",
            "fax_number": "708-406-3053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALI",
        "first_name": "MAHNAZ",
        "middle_name": "JEELANI",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-06",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "R1108",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.123445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zainab Alabd
• Carlos J Alberttis, DDS
• Christina Alex, MA
• Alexandre Family Health Center LTD
• Michelle J Alexandre, M.D.
• All Kids Dental Center, LLC
• Claude Allen, BA
• Jillian Allibone, SUDPT
• Nicole Marie Alvarez
• Holly Ambruso

• Family Medicine Physician in Melrose Park, IL
• Providers in Melrose Park, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.