Individual provider Active NPI

Jamaal Abdul Rehman, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • McHenry, IL
National Provider Identifier
1457709172
Registry record updated Jul 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
036148785 Issued in IL
Practice address
4201 W Medical Center Dr Ste 110
McHenry, IL 60050-8409
Phone
(815) 759-4806
Fax
(815) 759-4867
NPI assigned
Jun 3, 2016
Last updated
Jul 9, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 125068204 IL
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 036148785 IL Primary

Addresses

Primary practice location

4201 W Medical Center Dr Ste 110
McHenry, IL 60050-8409

Mailing address

4201 W Medical Center Dr Ste 110
McHenry, IL 60050-8409
Phone (815) 759-4806

Other practice location 1

2650 Ridge Ave
Suite 1304
Evanston, IL 60201-1718
Phone (217) 721-0797

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
I20210604000615 IL Practitioner - Pathology 9436441334 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10400 Haligus Rd
Huntley, IL 60142-9553

4201 W Medical Ctr Dr
McHenry, IL 60050-8409
Phone (815) 759-4323

4309 W Medical Ctr Dr
Suite A200
McHenry, IL 60050-8437
Phone (815) 759-8070

515 Valley View Dr
Suite 201
Moline, IL 61265-6175
Phone (312) 695-0870

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Lab 3 Inc CurrentSince Apr 1, 2022 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jul 1, 2021 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jul 1, 2021 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

820 E Terra Cotta Ave
Ste 216
Crystal Lake, IL 60014
Phone (224) 817-4973

2650 Ridge Ave
Ste 1304
Evanston, IL 60201
Phone (847) 570-2700

1800 McDonough Rd
Ste 209
Hoffman Estates, IL 60192
Phone (224) 238-3816

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

4201 W Medical Center Dr
Ste 110
McHenry, IL 60050
Phone (815) 759-4806

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

Organizations & group practices 3

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 4

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": "1464912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1457709172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 W MEDICAL CENTER DR STE 110",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508409",
            "telephone_number": "815-759-4806",
            "fax_number": "815-759-4867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 W MEDICAL CENTER DR STE 110",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508409",
            "telephone_number": "815-759-4806",
            "fax_number": "815-759-4867"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2650 Ridge Ave",
            "address_2": "Suite 1304",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "IL",
            "postal_code": "602011718",
            "country_code": "US",
            "telephone_number": "217-721-0797",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REHMAN",
        "first_name": "JAMAAL",
        "middle_name": "ABDUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-03",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "125068204",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "036148785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McHenry, IL

Sources for this page

Verify at the official NPI Registry.