Individual provider Active NPI

Mohammed Asif Mahkri, M.D.

  • Gastroenterology Physician
  • Aurora, IL
National Provider Identifier
1659351278
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036085150 Issued in IL
Practice address
2020 Ogden Ave
Suite 400
Aurora, IL 60504-5894
Phone
(630) 499-2442
Fax
(630) 499-2452
NPI assigned
Jan 19, 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
Gastroenterology Physician 207RG0100X 036085150 IL Primary

Addresses

Primary practice location

2020 Ogden Ave
Suite 400
Aurora, IL 60504-5894

Mailing address

2020 Ogden Ave
Suite 400
Aurora, IL 60504-5894
Phone (630) 499-2442

Other identifiers 1

IdentifierTypeStateIssuer
036085150MedicaidIL

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
I20051021000765 IL Practitioner - GastroenterologyPractitioner - Internal Medicine 9436175262 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

1505 Eastland Dr
Suite 1100
Bloomington, IL 61701-7905
Phone (309) 533-7455

2200 E Washington St
Bloomington, IL 61701-4364
Phone (309) 662-3311

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy62
Upper gastrointestinal (GI) endoscopy for acid reflux182

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Jan 1, 2016 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

1505 Eastland Dr
Bloomington, IL 61701
Phone (309) 663-2100

1505 Eastland Dr
Ste 500
Bloomington, IL 61701
Phone (309) 662-2273

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

Organizations & group practices 3

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 3

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": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659351278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 OGDEN AVE",
            "address_2": "SUITE 400",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605045894",
            "telephone_number": "630-499-2442",
            "fax_number": "630-499-2452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 OGDEN AVE",
            "address_2": "SUITE 400",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605045894",
            "telephone_number": "630-499-2442",
            "fax_number": "630-499-2452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHKRI",
        "first_name": "MOHAMMED",
        "middle_name": "ASIF",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036085150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036085150",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

Verify at the official NPI Registry.