Family Medicine of Illinois SC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036102332 Issued in IL

Legal business name

FAMILY MEDICINE OF ILLINOIS SC

Practice address

1507 S Falcon Dr
Libertyville, IL 60048-4897

Phone

(847) 494-0265

NPI assigned

May 6, 2008

Organization subpart

No

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

Authorized official

Name

Syeda Aisha Iftikhar, M.D.NPI 1770599938

Title

Physician

Phone

(224) 567-8371

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Syeda A. Iftikhar, M.D.

  • Internal Medicine Physician
  • Libertyville, IL
  • NPI 1770599938
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1210032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612310400000",
    "number": "1447426879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 S FALCON DR",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600484897",
            "telephone_number": "847-494-0265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 S FALCON DR",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600484897",
            "telephone_number": "847-494-0265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICINE OF ILLINOIS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-06",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A",
        "authorized_official_last_name": "IFTIKHAR",
        "authorized_official_first_name": "SYEDA",
        "authorized_official_middle_name": "AISHA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "224-567-8371",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036102332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036102332",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY SPECIALITY CODE",
            "identifier": "207R00000X",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL NUMBER",
            "identifier": "1770599938",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adam L Escobedo, APRN
• Alex Jose Escobedo, APRN
• Rochie Estrella, APN, CCRN, FNP-BC
• Evolve North I PLLC
• Family Care Medical Group, SC
• Family Partnership Associates
• Family Partnership Associates
• Nicole Fauquier, CCC-SLP
• Alyson Favela, MSN, APRN, FNP-C
• Alexandria Fedro, DACM

• Internal Medicine Physician in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.