Fairoaks Medical LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

FAIROAKS MEDICAL LLC

Doing business as

American Family Medical Center

Practice address

1254 Ogden Ave
Downers Grove, IL 60515-2740

Phone

(630) 963-6912

Fax

(630) 963-1499

NPI assigned

Sep 8, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Mohammad Vaseemuddin, M.D.NPI 1952453995

Title

Owner

Phone

(630) 876-9000

Specialties & licenses 2

Addresses

Other names 1

• AMERICAN FAMILY MEDICAL CENTER Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mohammad Vaseemuddin, M.D.

  • Internal Medicine Physician
  • Addison, IL
  • NPI 1952453995
  Medicare reassignment NPD Authorized official
• Shah A Alam, MD

  • Hospitalist Physician
  • Elmhurst, IL
  • NPI 1164450672
  Medicare reassignment NPD
• Ambar Josefina Cantu, FNP-BC

  • Family Nurse Practitioner
  • Chicago, IL
  • NPI 1144829714
  Medicare reassignment NPD
• Aisha Jaleel, MD

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1619968203
  Medicare reassignment NPD
• Monique Latrice Szczepanik, APRN, FNP-BC

  • Family Nurse Practitioner
  • Bolingbrook, IL
  • NPI 1558088427
  Medicare reassignment NPD
• Jabeen Fatima

  • Family Medicine Physician
  • Addison, IL
  • NPI 1497301832

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1410134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691971200000",
    "number": "1487055513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1254 OGDEN AVE",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605152740",
            "telephone_number": "630-963-6912",
            "fax_number": "630-963-1499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1254 OGDEN AVE",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605152740",
            "telephone_number": "630-963-6912",
            "fax_number": "630-963-1499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIROAKS MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-08",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A",
        "authorized_official_last_name": "VASEEMUDDIN",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-876-9000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AMERICAN FAMILY MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AMERICAN FAMILY MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Internal Medicine Physician in Downers Grove, IL
• Providers in Downers Grove, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.