Individual provider Active NPI

Zahidur Rahman, M. D.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1417975293
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-096554 Issued in IL
Practice address
7531 S Stony Island Ave
Chicago, IL 60649-3954
Phone
(773) 947-7764
Fax
(773) 947-2820
NPI assigned
Jul 18, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

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 036-096554 IL Primary

Addresses

Primary practice location

7531 S Stony Island Ave
Chicago, IL 60649-3954

Mailing address

7531 S Stony Island Ave
Chicago, IL 60649-3954
Phone (773) 947-7764

Other identifiers 1

IdentifierTypeStateIssuer
036-096554MedicaidIL

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
I20040122000593 IL Practitioner - Family Practice 9234031006 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Friedell Clinic, S. C.Group PAC ID 2567366164, 24 clinicians

Practice addresses (Care Compare)

1625 E 75TH St
FL 1
Chicago, IL 60649-3603

7531 S Stony Island Ave
Chicago, IL 60649-3954
Phone (773) 947-7764

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-096554ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Friedell Clinic, S. C. Family Medicine CurrentSince Jan 1, 1998 Accepting new patients
Ranganathan T LTD CurrentSince May 1, 2020 Accepting new patients
Jackson Park Hospital Foundation Current Accepting new patients
Associates in Behavioral Science, LTD. PastSince Sep 25, 2012 Accepting new patients
Metropolitan Behavioral Associates, Inc. PastSince Jul 16, 2018 Accepting new patients

Locations

1625 E 75th St
Chicago, IL 60649
Phone (773) 947-2828

190 E Delaware Pl
Chicago, IL 60611
Phone (312) 944-0063

7531 S Stony Island Ave
Chicago, IL 60649
Phone (773) 947-7310

7531 S Stony Island Ave
#251
Chicago, IL 60649

555 Wilson Ln
Des Plaines, IL 60016
Phone (212) 243-5565

Interoperability endpoints

  • Direct secure messaging: zahidurrahman@jph.medalliesdirect.net

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Jackson Park Hospital and Medical CenterChicago, IL, CCN 140177 Hospital Corporate Director Jun 30, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417975293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7531 S STONY ISLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606493954",
            "telephone_number": "773-947-7764",
            "fax_number": "773-947-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7531 S STONY ISLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606493954",
            "telephone_number": "773-947-7764",
            "fax_number": "773-947-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHMAN",
        "first_name": "ZAHIDUR",
        "name_prefix": "Dr.",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-096554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-096554",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.