Individual provider Active NPI

Muhammad Farris Fouad Al-Qawasmi

  • Student in an Organized Health Care Education/Training Program
  • Hickory Hills, IL
National Provider Identifier
1396502506
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
7715 W 91St PL
Hickory Hills, IL 60457-2087
Phone
(708) 300-4319
NPI assigned
Mar 4, 2024
Last updated
Mar 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

7715 W 91St PL
Hickory Hills, IL 60457-2087

Mailing address

7715 W 91St PL
Hickory Hills, IL 60457-2087

Other practice location 1

3000 Arlington Ave
Toledo, OH 43614-2598
Phone (419) 383-4229

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
I20250704000302 IL Order and Referring Only - AnesthesiologyPractitioner - Anesthesiology 3476067232

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: falqawasmi188782@uihealth.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1709510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1396502506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7715 W 91ST PL",
            "city": "HICKORY HILLS",
            "state": "IL",
            "postal_code": "604572087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7715 W 91ST PL",
            "city": "HICKORY HILLS",
            "state": "IL",
            "postal_code": "604572087",
            "telephone_number": "708-300-4319"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 Arlington Ave",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436142598",
            "country_code": "US",
            "telephone_number": "419-383-4229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AL-QAWASMI",
        "first_name": "MUHAMMAD FARRIS",
        "middle_name": "FOUAD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-04",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory Hills, IL

Sources for this page

Verify at the official NPI Registry.