Individual provider Active NPI

Iram Qazi, M.D

  • Child & Adolescent Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1457517708
Registry record updated Aug 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
125053830 Issued in IL
Practice address
2150 W Harrison St
Chicago, IL 60612-3706
Phone
(312) 942-7201
Fax
(312) 942-3113
NPI assigned
Aug 5, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 125053830 IL Primary

Addresses

Primary practice location

2150 W Harrison St
Chicago, IL 60612-3706

Mailing address

1404 W Harrison St Apt 1B
Chicago, IL 60607-3250
Phone (312) 576-8487

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
I20100210000390 IL Practitioner - Psychiatry 9234272493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Rush Medical College of Rush University, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dekalb Behavioral Health Foundation, Inc.Group PAC ID 9436451655, 20 clinicians

Practice addresses (Care Compare)

12 Health Services Dr
Dekalb, IL 60115-9637
Phone (815) 756-4875

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125053830ILMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dekalb Behavioral Health Foundation, Inc. CurrentSince Nov 1, 2015 Accepting new patients
Dekalb Behavioral Health Foundation, Inc. CurrentSince Nov 1, 2015 Accepting new patients

Locations

12 Health Services Dr
DeKalb, IL 60115
Phone (815) 756-4875

631 S 1st St
DeKalb, IL 60115
Phone (815) 756-4875

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1217894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217894400000",
    "number": "1457517708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 W HARRISON ST APT 1B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606073250",
            "telephone_number": "312-576-8487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123706",
            "telephone_number": "312-942-7201",
            "fax_number": "312-942-3113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QAZI",
        "first_name": "IRAM",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-05",
        "last_updated": "2008-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IL",
            "license": "125053830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.