NPIMap

Individual provider Active NPI

Syed Mohsin, M.D.

  • Internal Medicine Physician
  • Evergreen Park, IL
National Provider Identifier
1568474674
Registry record updated Mar 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036098660 Issued in IL
Practice address
2850 W 95TH St
Suite 106
Evergreen Park, IL 60805-2735
Phone
(708) 425-9399
Fax
(708) 425-9306
NPI assigned
Aug 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036098660 IL Primary

Addresses

Primary practice location

2850 W 95TH St
Suite 106
Evergreen Park, IL 60805-2735

Mailing address

2850 W 95TH St
Suite 106
Evergreen Park, IL 60805-2735
Phone (708) 425-9399

Other identifiers 1

IdentifierTypeStateIssuer
036098660MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050401000192 IL Practitioner - Internal MedicinePractitioner - Geriatric Medicine 3274580253 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2955 W 95TH St
Evergreen Park, IL 60805-2409
Phone (708) 425-9399

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036098660ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Primary Care, S.C. Internal Medicine CurrentSince Aug 1, 2001 Accepting new patients
Hama Medical Group LTD Internal Medicine CurrentSince Apr 1, 2016 Accepting new patients
Richard M Farrell, M.D., S.C. Internal Medicine Past Accepting new patients

Locations

2850 W 95th St
Ste 101
Evergreen Pk, IL 60805
Phone (708) 425-9550

2850 W 95th St
Ste 106
Evergreen Pk, IL 60805
Phone (708) 425-9399

2955 W 95th St
Evergreen Pk, IL 60805
Phone (708) 422-0022

5660 W 95th St
Ste 1
Oak Lawn, IL 60453
Phone (708) 499-2273

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3834/brand/1/csg/1/fhir/r4
  • Direct secure messaging: smohsin283218@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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268179200000",
    "number": "1568474674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 W 95TH ST",
            "address_2": "SUITE 106",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052735",
            "telephone_number": "708-425-9399",
            "fax_number": "708-425-9306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 W 95TH ST",
            "address_2": "SUITE 106",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052735",
            "telephone_number": "708-425-9399",
            "fax_number": "708-425-9306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHSIN",
        "first_name": "SYED",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2010-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036098660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036098660",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen Park, IL

Sources for this page

Verify at the official NPI Registry.