Active NPI
Mohammed Kaleemuddin, M.D.
- Family Medicine Physician
- Loves Park, IL
National Provider Identifier
1437119450
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01043590A
- Practice address
- 9951 Rock Cut Xing
Loves Park, IL 61111-1999 - Phone
- (815) 639-8450
- Fax
- (815) 639-8451
- NPI assigned
- Mar 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01043590A | IN | Primary |
Addresses
Primary practice location
9951 Rock Cut Xing
Loves Park, IL 61111-1999
Mailing address
9951 Rock Cut Xing
Loves Park, IL 61111-1999
Phone (815) 639-8450
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 553180 | Other | IL | MEDICARE GROUP NUMBER |
| 000000092799 | Other | IN | BCBS |
| 834340 | Other | IL | MEDICARE GROUP NUMBER |
| 200105080 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01043590A | IN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deaconess Hospital Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Health Counselor
- Evansville, IN
- NPI 1508723552
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1256688000000",
"number": "1437119450",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9951 ROCK CUT XING",
"city": "LOVES PARK",
"state": "IL",
"postal_code": "611111999",
"telephone_number": "815-639-8450",
"fax_number": "815-639-8451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9951 ROCK CUT XING",
"city": "LOVES PARK",
"state": "IL",
"postal_code": "611111999",
"telephone_number": "815-639-8450",
"fax_number": "815-639-8451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KALEEMUDDIN",
"first_name": "MOHAMMED",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-24",
"last_updated": "2009-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "01043590A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP NUMBER",
"identifier": "553180",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "000000092799",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP NUMBER",
"identifier": "834340",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200105080",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Loves Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.