Individual provider Active NPI

Tanvir Abdullah Bajwa Jr., DO

  • Cardiovascular Disease Physician
  • Park Ridge, IL
National Provider Identifier
1639752140
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036.167413 Issued in IL
Practice address
1875 W Dempster St Ste 525
Park Ridge, IL 60068-1130
Phone
(847) 698-5500
NPI assigned
May 3, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 1639752140 IL
Internal Medicine Physician 207R00000X 036167413 IL
Cardiovascular Disease Physician 207RC0000X 036.167413 IL Primary

Addresses

Primary practice location

1875 W Dempster St Ste 525
Park Ridge, IL 60068-1130

Mailing address

2650 Ridge Ave Ste 5323
Evanston, IL 60201-1700
Phone (847) 570-2505

Other practice location 1

5841 S Maryland Ave
Chicago, IL 60637-1443
Phone (847) 570-4789

Other practice location 2

2500 Ridge Ave Ste 300
Evanston, IL 60201-2455
Phone (847) 570-2700

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
I20240227001947 IL Practitioner - Internal Medicine 1254710684 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
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 Osteopathy

State licenses

LicenseStateTypeSpecialty
036167413ILMDInternal Medicine Physician
1639752140ILMDInternal Medicine Physician
036.167413ILMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Internal Medicine CurrentSince Feb 18, 2024 Accepting new patients
Endeavor Health Medical Group CurrentSince Feb 13, 2024 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 5323
Evanston, IL 60201
Phone (847) 570-2505

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2500 Ridge Ave
Ste 300
Evanston, IL 60201
Phone (847) 570-2700

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

1875 W Dempster St
Ste 525
Park Ridge, IL 60068
Phone (847) 698-3600

Interoperability endpoints

  • Direct secure messaging: tbajwa243537@direct.myadvocateaurora.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1639752140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE STE 5323",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "847-570-2505",
            "fax_number": "847-570-2905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 W DEMPSTER ST STE 525",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681130",
            "telephone_number": "847-698-5500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5841 S Maryland Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606371443",
            "country_code": "US",
            "telephone_number": "847-570-4789",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2500 Ridge Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "IL",
            "postal_code": "602012455",
            "country_code": "US",
            "telephone_number": "847-570-2700",
            "fax_number": "847-570-2822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAJWA",
        "first_name": "TANVIR",
        "middle_name": "ABDULLAH",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-03",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "1639752140",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036167413",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036.167413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.