Individual provider Active NPI

Manar Fayek-Ahmed Ismail, MD

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1639866635
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036.179646 Issued in IL
Practice address
2525 S Michigan Ave
Chicago, IL 60616-2315
Phone
(312) 567-2397
NPI assigned
Apr 19, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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 036.179646 IL Primary

Addresses

Primary practice location

2525 S Michigan Ave
Chicago, IL 60616-2315

Mailing address

2525 S Michigan Ave
Chicago, IL 60616-2315
Phone (312) 567-2397

Other names 1

  • Dr. Shamsan Ismail I Other name

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
I20230825000366 IL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 2860855798

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2003
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2000 Health Park Dr
Brentwood, TN 37027-4692

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.179646ILMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1681862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1639866635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 S MICHIGAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162315",
            "telephone_number": "312-567-2397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 S MICHIGAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162315",
            "telephone_number": "312-567-2397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISMAIL",
        "first_name": "MANAR",
        "middle_name": "FAYEK-AHMED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-19",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.179646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAMSAN",
            "last_name": "ISMAIL",
            "prefix": "DR.",
            "suffix": "I",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.