Individual provider Active NPI

Zewdu Haile, MD

  • Family Medicine Physician
  • Hinsdale, IL
National Provider Identifier
1639150121
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036091812 Issued in IL
Practice address
135 N Oak St
Hinsdale, IL 60521-3860
Phone
(630) 856-8900
NPI assigned
Nov 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036091812 IL Primary
Emergency Medicine Physician 207P00000X 036-091812 IL

Addresses

Primary practice location

135 N Oak St
Hinsdale, IL 60521-3860

Mailing address

135 N Oak St
Hinsdale, IL 60521-3860
Phone (630) 856-8900

Other practice location 1

200 E Fairman Ave
Watseka, IL 60970-1644
Phone (815) 432-5841

Other identifiers 1

IdentifierTypeStateIssuer
821050OtherILMEDICARE GROUP PTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address zewdu.haile.1@15486.direct.athenahealth.com Direct

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040415000051 IL Practitioner - Family Practice 1850386418 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iems Physician Services PLLCGroup PAC ID 2567802556, 64 clinicians

Practice addresses (Care Compare)

1400 W Park St
Urbana, IL 61801-2334
Phone (217) 337-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-091812ILMDEmergency Medicine Physician
036091812ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iroquois Memorial Hospital and Resident Home CurrentSince Aug 16, 2018 Accepting new patients
Gibson Community Hospital Association Family Medicine CurrentSince Jul 1, 2021 Accepting new patients
Gibson Community Hospital Association CurrentSince Jul 1, 2021 Accepting new patients
Iems Physician Services PLLC Emergency Medicine CurrentSince Apr 20, 2024 Accepting new patients
Gibson Community Hospital Association Current Accepting new patients
Illinois Emergency Medicine Specialists, LLC CurrentSince Mar 1, 2023 Accepting new patients
Statera Health Care, LLC Emergency Medicine CurrentSince May 1, 2023 Accepting new patients

Locations

500 Remington Blvd
Bolingbrook, IL 60440
Phone (630) 312-5000

180 S Main St
Canton, IL 61520
Phone (309) 647-5240

2250 N Illinois Ave
Carbondale, IL 62901
Phone (618) 833-1691

2525 S Michigan Ave
Chicago, IL 60616
Phone (312) 355-1153

812 N Logan Ave
Danville, IL 61832
Phone (217) 443-5000

1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684

7 Doctors Park
Gibson City, IL 60936
Phone (217) 784-5500

135 N Oak St
Hinsdale, IL 60521
Phone (630) 856-8900

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

611 S Marshall Ave
Mc Leansboro, IL 62859
Phone (618) 542-2146

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

530 Park Ave E
Princeton, IL 61356
Phone (815) 875-2811

1400 W Park St
Urbana, IL 61801
Phone (217) 337-2000

200 E Fairman Ave
Watseka, IL 60970
Phone (815) 432-5201

Organizations & group practices 8

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 1

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": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1639150121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 N OAK ST",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213860",
            "telephone_number": "630-856-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 N OAK ST",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213860",
            "telephone_number": "630-856-8900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 E Fairman Ave",
            "address_purpose": "LOCATION",
            "city": "Watseka",
            "state": "IL",
            "postal_code": "609701644",
            "country_code": "US",
            "telephone_number": "815-432-5841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAILE",
        "first_name": "ZEWDU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036091812",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-091812",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "821050",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "zewdu.haile.1@15486.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Use with Watseka location",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "200 E Fairman Ave",
            "city": "Watseka",
            "state": "IL",
            "country_code": "US",
            "postal_code": "609701644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hinsdale, IL

Sources for this page

Verify at the official NPI Registry.