Individual provider Active NPI

Maryam Moeed, DO

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1447831615
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
81815-21 Issued in WI
Practice address
1500 S Fairfield Ave
Chicago, IL 60608-1782
Phone
(773) 257-5701
Fax
(773) 257-6027
NPI assigned
Apr 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 81815-21 WI Primary

Addresses

Primary practice location

1500 S Fairfield Ave
Chicago, IL 60608-1782

Mailing address

1500 S Fairfield Ave
Chicago, IL 60608-1782
Phone (773) 257-5701

Other practice location 1

3 Erie Ct Ste L700
Oak Park, IL 60302-2519
Phone (708) 763-1222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20250318001512 WI Practitioner - Internal Medicine 4880096619 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Group practices
Apogee Medical Group Waukesha SCGroup PAC ID 1153670054, 43 clinicians

Practice addresses (Care Compare)

725 American Ave
Waukesha, WI 53188-5031
Phone (262) 928-5400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group Waukesha, SC CurrentSince Mar 12, 2025 Accepting new patients

Locations

240 Maple Ave
Mukwonago, WI 53149
Phone (262) 928-1900

791 Summit Ave
Summit, WI 53066
Phone (262) 569-0251

725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011

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.

Hospital & facility affiliations 3

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": "1618790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1447831615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S FAIRFIELD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081782",
            "telephone_number": "773-257-5701",
            "fax_number": "773-257-6027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S FAIRFIELD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081782",
            "telephone_number": "773-257-5701",
            "fax_number": "773-257-6027"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Erie Ct Ste L700",
            "address_purpose": "LOCATION",
            "city": "Oak Park",
            "state": "IL",
            "postal_code": "603022519",
            "country_code": "US",
            "telephone_number": "708-763-1222",
            "fax_number": "708-763-1471",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOEED",
        "first_name": "MARYAM",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-19",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "81815-21",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.