Individual provider Active NPI

Mouyyad Wakaa Rahaby, MD.

  • Clinical Cardiac Electrophysiology Physician
  • Libertyville, IL
National Provider Identifier
1528207537
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
5431220 Issued in WI
Practice address
900 Technology Way
Suite 220
Libertyville, IL 60048-5364
Phone
(847) 367-7171
Fax
(847) 367-7177
NPI assigned
Feb 13, 2009
Last updated
Jul 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036118564 IL
Cardiovascular Disease Physician 207RC0000X 036-118564 IL
Clinical Cardiac Electrophysiology Physician 207RC0001X 5431220 WI Primary
Clinical Cardiac Electrophysiology Physician 207RC0001X 036118564 IL

Addresses

Primary practice location

900 Technology Way
Suite 220
Libertyville, IL 60048-5364

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

10400 75th St
Kenosha, WI 53142-7884
Phone (262) 948-5600

Other identifiers 1

IdentifierTypeStateIssuer
100015486MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mrahaby236270@direct.myadvocateaurora.org
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110331000059 IL Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 0244413144 Reassigns benefits to 1 organization
I20110615000155 WI Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 0244413144

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology), Critical Care (Intensivists), Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

450 W Hwy 22
Neonatology
Barrington, IL 60010-1919
Phone (847) 381-0123

525 E Congress Pkwy
Crystal Lake, IL 60014-6258

801 S Milwaukee Ave
Libertyville, IL 60048-3204
Phone (847) 279-0061

801 S Milwaukee Ave BLDG
Suite 880
Libertryville, IL 60048-3204
Phone (847) 990-5910

900 Technology Way
Suite 220
Libertyville, IL 60048-5364
Phone (847) 367-7171

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-118564ILMDCardiovascular Disease Physician
5431220WIMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Nov 30, 2021 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Nov 30, 2021 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

900 Technology Way
Ste 220
Libertyville, IL 60048

Interoperability endpoints

  • Direct secure messaging: mrahaby236270@direct.myadvocateaurora.org

Organizations & group practices 3

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1234483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1528207537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 TECHNOLOGY WAY",
            "address_2": "SUITE 220",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485364",
            "telephone_number": "847-367-7171",
            "fax_number": "847-367-7177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10400 75th St",
            "address_purpose": "LOCATION",
            "city": "Kenosha",
            "state": "WI",
            "postal_code": "531427884",
            "country_code": "US",
            "telephone_number": "262-948-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAHABY",
        "first_name": "MOUYYAD",
        "middle_name": "WAKAA",
        "name_prefix": "Dr.",
        "credential": "MD.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-13",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036118564",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036-118564",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "WI",
            "license": "5431220",
            "primary": true
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "IL",
            "license": "036118564",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100015486",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mrahaby236270@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "900 Technology Way",
            "address_2": "Suite 220",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600485364",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "900 Technology Way",
            "address_2": "Suite 220",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600485364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

Verify at the official NPI Registry.