Active NPI
Rehan Ahmed Nizamuddin, M.D.
- Diagnostic Radiology Physician
- Evanston, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 036156032
- Practice address
- 2650 Ridge Ave
Suite 1304
Evanston, IL 60201-1718 - Phone
- (224) 639-6624
- NPI assigned
- May 2, 2016
- Last updated
- Apr 29, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 125068937 | IL | |
| Diagnostic Radiology Physician | 2085R0202X | 2018014985 | MO | |
| Diagnostic Radiology Physician | 2085R0202X | 036156032 | IL | Primary |
Addresses
Primary practice location
2650 Ridge Ave
Suite 1304
Evanston, IL 60201-1718
Mailing address
2650 Ridge Ave.
Dept. of Radiology
Evanston, IL 60201-1057
Phone (847) 570-2477
Other practice location 1
676 N Saint Clair St Ste 800
Chicago, IL 60611-2978
Phone (312) 695-5753
Other practice location 2
1 Barnes Jewish Hospital Plz
Saint Louis, MO 63110-1003
Phone (314) 362-5000
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
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- University of Missouri, Kansas City, School of Medicine, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2650 Ridge Ave
Suite 2218a
Evanston, IL 60201-1700
Phone (847) 503-4222
Hospital & facility affiliations
- Northshore University Healthsystem - Evanston Hospital
- Swedish Hospital
- Northwestern Memorial Hospital
- Advocate Lutheran General Hospital
- Northwestern Medicine Central Dupage Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.9 of 100
- Quality
- 75.91
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 74.6
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036156032 | IL | MD | Diagnostic Radiology Physician |
| 2018014985 | MO | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Endeavor Health Medical Group | Current | Accepting new patients | |
| Northwestern Medical Faculty Foundation | Diagnostic Radiology | Current | Accepting new patients |
| Northwestern Medical Faculty Foundation | Current | Accepting new patients | |
| Endeavor Health Medical Group | Family Medicine | Current | Accepting new patients |
Locations
Dept 5777
Carol Stream, IL 60122
676 N Saint Clair St
Ste 1725
Chicago, IL 60611
Phone (312) 664-8533
676 N Saint Clair St
Ste 800
Chicago, IL 60611
Phone (312) 695-5753
9532 Eagle Way
Chicago, IL 60678
2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206
2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172
2650 Ridge Ave
Ste 1304
Evanston, IL 60201
Phone (847) 570-2700
2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222
660 N Westmoreland Rd
#302
Lake Forest, IL 60045
Organizations & group practices 4
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.
-
dba NorthShore University HealthSystem Faculty Practice Associates
- Emergency Medicine Physician
- Evanston, IL
- NPI 1497701882
Family Medicine
-
dba Northwestern Medical Group
- Multi-Specialty Clinic/Center
- Carol Stream, IL
- NPI 1346235314
Diagnostic Radiology
-
dba NorthShore Anesthesia Group
- Anesthesiology Physician
- Evanston, IL
- NPI 1265695944
-
dba Northwestern Medical Group
- Durable Medical Equipment & Medical Supplies
- Chicago, IL
- NPI 1417718479
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Advocate Lutheran General Hospital
- General Acute Care Hospital
- Park Ridge, IL
- NPI 1164539730
-
dba Northwestern Medicine Central Dupage Hospital
- General Acute Care Hospital
- Winfield, IL
- NPI 1003864810
-
dba Northwestern Medicine Central Dupage Hospital
- Psychiatric Hospital Unit
- Winfield, IL
- NPI 1740230895
-
dba Endeavor Health Evanston Hospital
- General Acute Care Hospital
- Evanston, IL
- NPI 1184670549
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1497859649
-
dba Endeavor Health Swedish Hospital
- General Acute Care Hospital
- Chicago, IL
- NPI 1831151257
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651190400000",
"number": "1619322252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2650 RIDGE AVE.",
"address_2": "DEPT. OF RADIOLOGY",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602011057",
"telephone_number": "847-570-2477",
"fax_number": "847-570-2942"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2650 RIDGE AVE",
"address_2": "SUITE 1304",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602011718",
"telephone_number": "224-639-6624"
}
],
"practiceLocations": [
{
"address_1": "676 N Saint Clair St Ste 800",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606112978",
"country_code": "US",
"telephone_number": "312-695-5753",
"fax_number": "312-695-5645",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1 Barnes Jewish Hospital Plz",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631101003",
"country_code": "US",
"telephone_number": "314-362-5000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NIZAMUDDIN",
"first_name": "REHAN",
"middle_name": "AHMED",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-05-02",
"last_updated": "2022-04-29",
"certification_date": "2022-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "125068937",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MO",
"license": "2018014985",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "IL",
"license": "036156032",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Evanston, IL
- Esha Rani Kumar Nikore, PHD
- Swarupa Injeti Nimmagadda, M.D.
- Laura Nitahara, APN-CNP
- Karoon Nititham, M.D.
- Martin Nitsun, M.D.
- Cornelia Adaji Nkwocha
- Nolan K M Chun DDS PC (Evanston Dental Care)
- Robert J. Noone, PH.D
- Christopher Nora, MS, MA, LPC, LCPC
- North Shore Associates in Gynecology and Obstetrics, S.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; 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.