Shaheen Fatima Misbah, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036133955 Issued in IL

Practice address

1015 Summit St
Elgin, IL 60120

Phone

(847) 289-8355

NPI assigned

Jun 21, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Family Practice

Education

Rush Medical College of Rush University, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bonaventure Medical Foundation LLCGroup PAC ID 7517863178, 164 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Alexius Medical Center Hospital, Hoffman Estates, IL, CCN 140290

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Bonaventure Medical Foundation, LLC

  • Family Medicine Physician
  • Elk Grove Village, IL
  • NPI 1588775647
  Medicare reassignment Care Compare group NPD
• Physicians Immediate Care North Chicago LLC

  • Urgent Care Clinic/Center
  • Chicago, IL
  • NPI 1205814118
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Alexius Medical Center

  • General Acute Care Hospital
  • Hoffman Estates, IL
  • NPI 1376644385
  Care Compare affiliation

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

{
    "created_epoch": "1308614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1649566407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 SUMMIT ST",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601204362",
            "telephone_number": "847-289-8355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 SUMMIT ST",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "60120",
            "telephone_number": "847-289-8355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISBAH",
        "first_name": "SHAHEEN",
        "middle_name": "FATIMA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-21",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036133955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036133955",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shaheen.misbah.1@380.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "1015 Summit St",
            "city": "Elgin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christopher Mills, NP
• Charles Alan Milofsky, ED.D.
• Dean Milosch
• Anthony Mirabella
• Patrick Miranda
• Syed Muhammad Misbahuddin, DDS
• Qaynat S Mithani, DO
• Katherine Helen Mittelbrun
• Ellen Michelle Mlot, D.O.
• Mme Servies, LTD

• Family Medicine Physician in Elgin, IL
• Providers in Elgin, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.