Individual provider Active NPI

Delaram Majlesi, M.D.

  • Internal Medicine Physician
  • McHenry, IL
National Provider Identifier
1457973109
Registry record updated Sep 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
125.077188 Issued in IL
Practice address
4201 Medical Center Drive
McHenry, IL 60050
Phone
(815) 338-6600
Fax
(815) 759-8255
NPI assigned
May 15, 2020
Last updated
Sep 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125.077188 IL Primary

Addresses

Primary practice location

4201 Medical Center Drive
McHenry, IL 60050

Mailing address

4309 W Shamrock LN
Apt #2C
McHenry, IL 60050
Phone (815) 759-4726

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
I20231012000340 IL Practitioner - Internal Medicine 1557716495 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.077188ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cimpar, S.C. Internal Medicine CurrentSince Oct 1, 2023 Accepting new patients

Locations

101 Madison St
Ste 300
Oak Park, IL 60302
Phone (773) 849-9406

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1589500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599004800000",
    "number": "1457973109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4309 W SHAMROCK LN",
            "address_2": "APT #2C",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "60050",
            "telephone_number": "815-759-4726",
            "fax_number": "815-759-8255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 MEDICAL CENTER DRIVE",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "60050",
            "telephone_number": "815-338-6600",
            "fax_number": "815-759-8255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAJLESI",
        "first_name": "DELARAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-15",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.077188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McHenry, IL

Sources for this page

Verify at the official NPI Registry.