Individual provider Active NPI

Rahman Fazil Mohammed Abdul, M.D.

  • Adult Medicine Physician
  • Des Plaines, IL
National Provider Identifier
1629411806
Registry record updated Jun 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
036.136984 Issued in IL
Practice address
9011 W Ballard Rd Apt 1a
Des Plaines, IL 60016-4987
Phone
(224) 717-9196
NPI assigned
Apr 8, 2013
Last updated
Jun 23, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 036.136984 IL Primary

Addresses

Primary practice location

9011 W Ballard Rd Apt 1a
Des Plaines, IL 60016-4987

Mailing address

9011 W Ballard Rd Apt 1a
Des Plaines, IL 60016-4987
Phone (224) 717-9196

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20181015002581 TX Practitioner - Family PracticePractitioner - Emergency Medicine 5799080131 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.136984ILMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Services of Texas PA CurrentSince Oct 1, 2018 Accepting new patients
Hospitalist Medicine Physicians of Texas - Cypress PLLC CurrentSince Sep 4, 2024 Accepting new patients
Sterling Initiatives CurrentSince May 31, 2024 Accepting new patients
Sterling Initiatives CurrentSince May 31, 2024 Accepting new patients
24 Hour Physicians, Inc CurrentSince Jan 1, 2019 Accepting new patients
Star MD, PLLC CurrentSince Jul 1, 2020 Accepting new patients

Locations

26791 US Highway 380 E
Aubrey, TX 76227
Phone (972) 347-2525

504 Lipscomb St
Bonham, TX 75418
Phone (903) 583-8585

9440 Poppy Dr
Dallas, TX 75218
Phone (214) 324-6100

1801 N Oregon St
El Paso, TX 79902
Phone (409) 883-9361

1917 Ashland St
Houston, TX 77008
Phone (713) 861-6161

620 S Main St
Keller, TX 76248
Phone (214) 294-6100

620 S Main St
Ste 100
Keller, TX 76248
Phone (214) 294-6100

511 W FM 544
Ste 100
Murphy, TX 75094
Phone (214) 294-6150

1604 West Ave
San Antonio, TX 78201
Phone (210) 572-8885

1498 Pacific Ave
Ste 500
Tacoma, WA 98402
Phone (253) 682-6040

Interoperability endpoints

  • Direct secure messaging: rahman.mohammedabdul.1@18822.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1365379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466640000000",
    "number": "1629411806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9011 W BALLARD RD APT 1A",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600164987",
            "telephone_number": "224-717-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9011 W BALLARD RD APT 1A",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600164987",
            "telephone_number": "224-717-9196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMMED ABDUL",
        "first_name": "RAHMAN",
        "middle_name": "FAZIL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-08",
        "last_updated": "2016-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "IL",
            "license": "036.136984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Plaines, IL

Sources for this page

Verify at the official NPI Registry.