Ahmed Ali Tariq, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036110691 Issued in IL

Practice address

1201 Pine St
Eldorado, IL 62930-1634

Phone

(618) 273-3361

NPI assigned

Dec 27, 2005

Last updated

Feb 8, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aatariq@yourcarecommunity.org

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.

• Granite City Hospitalist Services LLC

  • Hospitalist Physician
  • Carbondale, IL
  • NPI 1669926424
  Medicare reassignment NPD
• Illinois Department of Human Services

  • Intellectual Disabilities Intermediate Care Facility
  • Centralia, IL
  • NPI 1003960394
  Medicare reassignment NPD
• Integritas Emergency Physician Services, LLC

  • Emergency Medicine Physician
  • Carbondale, IL
  • NPI 1790128817
  Medicare reassignment NPD
• Sound Physicians of Illinois, LLC

  • Hospitalist Physician
  • Bridgeton, MO
  • NPI 1043598865

  IL, Internal Medicine

  Medicare reassignment NPD
• Illinois Department of Human Services

  • Psychiatric Hospital
  • Chester, IL
  • NPI 1306834726
  NPD
• Illinois Department of Human Services

  dba John J Madden Mental Health

  • Psychiatric Hospital
  • Hines, IL
  • NPI 1902903487
  NPD
• Memorial Hospital Association

  dba Women & Family Medical Group

  • Rural Health Clinic/Center
  • Carthage, IL
  • NPI 1205887742
  NPD
• Memorial Hospital Association

  dba Memorial Medical Clinic Broadway

  • Rural Health Clinic/Center
  • Hamilton, IL
  • NPI 1679327779
  NPD
• Memorial Hospital Association

  • Critical Access Hospital
  • Carthage, IL
  • NPI 1730139031
  NPD
• Thomas H. Boyd Memorial Hospital

  • Skilled Nursing Facility
  • Carrollton, IL
  • NPI 1699973685
  NPD (past)

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486512000000",
    "number": "1508843996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 REMIT DR",
            "address_2": "STE 1122",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606751122",
            "telephone_number": "866-916-5259",
            "fax_number": "231-922-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 PINE ST",
            "city": "ELDORADO",
            "state": "IL",
            "postal_code": "629301634",
            "telephone_number": "618-273-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARIQ",
        "first_name": "AHMED",
        "middle_name": "ALI",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-27",
        "last_updated": "2017-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036110691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gretchen L Sutton, P.A.
• Craig V Svoboda, MD
• Octavia Swango, MSW
• Tonya Dea Taylor, LCSW
• Jessica Lynne Tepe
• Franko Gilbert Teston
• Melanie Nicole Tharp, MS, RD
• Gayla Titsworth

• Internal Medicine Physician in Eldorado, IL
• Providers in Eldorado, 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 Feb 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.