Individual provider Active NPI

Thayer Hamoudah, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1568843209
Registry record updated Jun 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
125067477 Issued in IL
Practice address
1653 W Congress Pkwy
Chicago, IL 60612-3833
Phone
(312) 942-5000
NPI assigned
Jun 17, 2015
Last updated
Jun 17, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2015

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 125067477 IL Primary

Addresses

Primary practice location

1653 W Congress Pkwy
Chicago, IL 60612-3833

Mailing address

1653 W Congress Pkwy
Chicago, IL 60612-3833

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
I20210915001715 IL Practitioner - GastroenterologyPractitioner - Internal Medicine 2769774611 Reassigns benefits to 3 organizations
I20250418000971 WI Practitioner - Gastroenterology 2769774611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health System CorporationGroup PAC ID 7416860440, 749 clinicians
Rockford Health PhysiciansGroup PAC ID 2567374036, 520 clinicians

Practice addresses (Care Compare)

1000 Mineral Point Ave
Janesville, WI 53548-2940
Phone (608) 756-6000

2350 N Rockton Ave
Rockford, IL 61103-3600
Phone (815) 971-2000

901 Grant St
Harvard, IL 60033-1821
Phone (815) 943-5431

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy68
Upper gastrointestinal (GI) endoscopy for acid reflux140

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Health Physicians CurrentSince Aug 16, 2021 Accepting new patients
Mercy Health System Corporation Current Accepting new patients
Mercy Harvard Hospital Inc CurrentSince Dec 1, 2025 Accepting new patients
Mercy Harvard Hospital Inc CurrentSince Dec 1, 2025 Accepting new patients
Mercy Health System Corporation CurrentSince Feb 13, 2025 Accepting new patients
Mercy Health System Corporation CurrentSince Feb 13, 2025 Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

875 S State Route 31
Crystal Lake, IL 60014
Phone (779) 220-5500

348 S Division St
Harvard, IL 60033
Phone (815) 943-1122

901 Grant St
Harvard, IL 60033
Phone (815) 943-2961

2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510

2350 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-2200

8201 E Riverside Blvd
Rockford, IL 61114
Phone (815) 971-4066

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

Interoperability endpoints

  • Direct secure messaging: thamoudah84009@direct.mhemail.org

Organizations & group practices 6

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 2

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": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434499200000",
    "number": "1568843209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1653 W CONGRESS PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1653 W CONGRESS PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123833",
            "telephone_number": "312-942-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMOUDAH",
        "first_name": "THAYER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-17",
        "last_updated": "2015-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125067477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.