Muhammad Ali Memon, MD
Individual provider Active NPI Internal Medicine Physician · Cairo, IL
NPI 1467571497 · NPPES record last updated Dec 9, 2009
Key facts
- NPI
- 1467571497
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 036-112154 (IL)
- Practice address
- 13245 Kessler Rd
Cairo, IL 62914-3101 - Phone
- (618) 734-4400
- Fax
- (618) 734-2884
- NPI assigned
- Mar 29, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Osf Multi-Specialty Group
Sound Physicians of Illinois LLC
Practice addresses (Care Compare)
1400 W Park St
Urbana, IL 61801-2334
Phone (217) 337-2000
812 N Logan Ave
Danville, IL 61832-3752
Phone (217) 443-5000
8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050
Hospital & facility affiliations
- Osf Sacred Heart Medical Center
- Carle Bromenn Medical Center
- Osf Heart of Mary Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070522000027 | IL | Practitioner - Internal Medicine |
8820195100 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-112154 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carle West Physician Group Inc | Current |
Accepting new patients | |
| Sound Physicians of Illinois, LLC | Internal Medicine | Current |
Accepting new patients |
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Osf Multi-Specialty Group | Internal Medicine | Current |
Accepting new patients |
| Carle Eureka Hospital | Current |
Accepting new patients | |
| Carle Health Care Incorporated | Past | Accepting new patients |
Locations
2204 Eastland Dr
Bloomington, IL 61704
Phone (309) 662-9461
1044 N Francisco Ave
Chicago, IL 60622
Phone (773) 292-8227
812 N Logan Ave
Danville, IL 61832
Phone (217) 443-5000
101 S Major St
Eureka, IL 61530
Phone (309) 268-2172
525 E Grant St
Macomb, IL 61455
Phone (309) 836-1611
8 Doctors Park Rd
Mount Vernon, IL 62864
Phone (618) 244-5500
1304 Franklin Ave
Normal, IL 61761
Phone (309) 268-3590
1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
1600 W Walnut St
South Jacksonville, IL 62650
Phone (217) 245-7275
1400 W Park St
Urbana, IL 61801
Phone (217) 337-2000
611 W Park St
Urbana, IL 61801
Phone (217) 383-6941
Interoperability endpoints
- mmemon@yourcarecommunity.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036-112154 | IL | Yes |
Addresses
Primary practice location
13245 Kessler Rd
Cairo, IL 62914-3101
Mailing address
13245 Kessler Rd
Cairo, IL 62914-3101
Phone (618) 734-4400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036112154 | Medicaid | IL |
Other providers in Cairo, IL
- Robin Lynn Lutker
- Julie Kay Mason
- Brittany Matthews
- Margaret McKenzie
- Medcare Inc
- Amir Namazi
- Glenn A Parker
- Pilot House
- Linda Poindexter
- Debra Joy Powell
All providers in Cairo, IL · Internal Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 9, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.