Active NPI
Syed Irfan, M.D.
- Psychiatry Physician
- Rockford, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 036115936
- Practice address
- 2819 Glenwood Ave
Rockford, IL 61101-3542 - Phone
- (815) 971-4060
- Fax
- (815) 971-9060
- NPI assigned
- Jul 1, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Anatomic Pathology Physician
- Rockford, IL
- NPI 1184671992
-
- Community/Retail Pharmacy
- Patton, PA
- NPI 1578541413
-
- Skilled Nursing Facility
- Rockford, IL
- NPI 1760075394
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Osf Multi-Specialty Group
Practice addresses (Care Compare)
2800 W 95TH St
Evergreen, IL 60805-2701
Phone (708) 499-2070
330 SW Adams St
Peoria, IL 61602-1502
Phone (309) 655-2877
8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20061023000111 | IL | Practitioner - Psychiatry | 0143227868 | Reassigns benefits to 2 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036115936 | IL | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rockford Health Physicians | Current | Accepting new patients | |
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| RMH Pathologists, LTD | Current | Accepting new patients | |
| Osf Multi-Specialty Group | Current | Accepting new patients | |
| Javon Bea Hospital | Past | Accepting new patients |
Locations
29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195
2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510
2709 Glenwood Ct
Rockford, IL 61101
Phone (815) 971-4060
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 036115936 | IL | Primary |
Addresses
Primary practice location
2819 Glenwood Ave
Rockford, IL 61101-3542
Mailing address
2819 Glenwood Ave
Rockford, IL 61101-3542
Phone (815) 971-4060
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036115936 | Other | IL | STATE LICENSE |
NPI Registry JSON
{
"created_epoch": "1151712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348531200000",
"number": "1508895897",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2819 GLENWOOD AVE",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611013542",
"telephone_number": "815-971-4060",
"fax_number": "815-971-9060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2819 GLENWOOD AVE",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611013542",
"telephone_number": "815-971-4060",
"fax_number": "815-971-9060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IRFAN",
"first_name": "SYED",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-01",
"last_updated": "2012-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": "036115936",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "036115936",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2012; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.