Individual provider Active NPI

Imtiaz Hamid, MD

  • Cardiovascular Disease Physician
  • Homewood, IL
National Provider Identifier
1508857061
Registry record updated Apr 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Practice address
17901 Governors Hwy
Suite 101
Homewood, IL 60430-1144
Phone
(708) 799-0180
Fax
(708) 799-3839
NPI assigned
Nov 3, 2005
Last updated
Apr 2, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X IL Primary

Addresses

Primary practice location

17901 Governors Hwy
Suite 101
Homewood, IL 60430-1144

Mailing address

17901 Governors Hwy
Suite 101
Homewood, IL 60430-1144
Phone (708) 799-0180

Other identifiers 2

IdentifierTypeStateIssuer
CB1134OtherILRR MEDICARE
21624320OtherILBCBS OF IL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Suburban Cardiology LTD Cardiovascular Disease CurrentSince Jan 1, 1999 Accepting new patients

Locations

1 Ingalls Dr
Harvey, IL 60426
Phone (708) 333-2300

71 W 156th St
Ste 108
Harvey, IL 60426
Phone (708) 388-0499

17901 Governors Hwy
Ste 101
Homewood, IL 60430
Phone (708) 799-0180

17901 Governors Hwy
Ste 203
Homewood, IL 60430
Phone (708) 922-0180

4647 Lincoln Hwy
Matteson, IL 60443
Phone (708) 481-9912

Organizations & group practices 2

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": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207094400000",
    "number": "1508857061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17901 GOVERNORS HWY",
            "address_2": "SUITE 101",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604301144",
            "telephone_number": "708-799-0180",
            "fax_number": "708-799-3839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17901 GOVERNORS HWY",
            "address_2": "SUITE 101",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604301144",
            "telephone_number": "708-799-0180",
            "fax_number": "708-799-3839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMID",
        "first_name": "IMTIAZ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2008-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CB1134",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL",
            "identifier": "21624320",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Homewood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.