Individual provider Active NPI

Mohammed Hussain, MD

  • Cardiovascular Disease Physician
  • Chicago, IL
National Provider Identifier
1649339441
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036069756 Issued in IL
Practice address
3960 N Harlem Ave
Chicago, IL 60634-2219
Phone
(773) 589-1008
Fax
(773) 658-2005
NPI assigned
Dec 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 036069756 IL Primary

Addresses

Primary practice location

3960 N Harlem Ave
Chicago, IL 60634-2219

Mailing address

3401 W Devon Ave
PO Box 59436
Chicago, IL 60659-1303

Other identifiers 1

IdentifierTypeStateIssuer
036069756MedicaidIL

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
I20040505000861 IL Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 0648268813 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3960 N Harlem Ave
Chicago, IL 60634-2267
Phone (773) 589-1008

Hospital & facility affiliations

  • Evangel Home Health Services, Inc Home health agency, Schaumburg, IL, CCN 147944
  • Auxilium Healthcare Services, Inc Home health agency, South Barrington, IL, CCN 148308
  • Community First Medical Center Hospital, Chicago, IL, CCN 140251
  • Amita Health Resurrection Medical Center Hospital, Chicago, IL, CCN 140117
  • Grove of Skokie, the Nursing home, Skokie, IL, CCN 145860
  • Norridge Gardens Nursing home, Norridge, IL, CCN 145329
  • Community First Medical Center Nursing home, Chicago, IL, CCN 145548

Merit-based Incentive Payment System (MIPS)

Final score
40.67 of 100Reported as individual
Quality
15
Improvement activities
0
Cost
84.03

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036069756ILMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
HKH Associates SC Cardiovascular Disease CurrentSince Jan 1, 1980 Accepting new patients

Locations

3401 W Devon Ave
Unit 59436
Chicago, IL 60659

3960 N Harlem Ave
Chicago, IL 60634
Phone (773) 589-2400

5645 W Addison St
Chicago, IL 60634
Phone (773) 282-7000

Organizations & group practices 1

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.

Hospital & facility affiliations 7

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": "1165449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649339441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 W DEVON AVE",
            "address_2": "PO BOX 59436",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606591303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3960 N HARLEM AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606342219",
            "telephone_number": "773-589-1008",
            "fax_number": "773-658-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSSAIN",
        "first_name": "MOHAMMED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036069756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036069756",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.