Individual provider Active NPI

Mohanad Joudeh, M.D.

  • Internal Medicine Physician
  • Zion, IL
National Provider Identifier
1659546414
Registry record updated Aug 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036127003 Issued in IL
Practice address
2520 Elisha Ave
Zion, IL 60099-2676
Phone
(847) 731-5050
NPI assigned
Apr 23, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2015

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 036127003 IL Primary

Addresses

Primary practice location

2520 Elisha Ave
Zion, IL 60099-2676

Mailing address

1860 Paysphere Cir
Chicago, IL 60674-0018
Phone (815) 741-2900

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
I20130930000344 IL Practitioner - Internal Medicine 0143454413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Louisiana State University School of Medicine in New Orleans, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ucm Medical Group Sub LLCGroup PAC ID 4688635337, 101 clinicians

Practice addresses (Care Compare)

6703 159TH St
Suite 103
Tinley Park, IL 60477-1782
Phone (708) 342-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036127003ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ucm Medical Group Sub, LLC Internal Medicine CurrentSince Apr 28, 2021 Accepting new patients
City of Hope Medical Group of Illinois PLLC Past Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

27702 Network Pl
Chicago, IL 60673

1 Ingalls Dr
Harvey, IL 60426
Phone (708) 333-2300

6701 159th St
Ste 103
Tinley Park, IL 60477
Phone (708) 429-3300

6703 159th St
Ste 103
Tinley Park, IL 60477
Phone (708) 532-6490

Interoperability endpoints

  • Direct secure messaging: mjoudeh209306@uchospital.direct-ci.com

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.

Hospital & facility affiliations 2

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": "1208908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440460800000",
    "number": "1659546414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 PAYSPHERE CIR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606740018",
            "telephone_number": "815-741-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 ELISHA AVE",
            "city": "ZION",
            "state": "IL",
            "postal_code": "600992676",
            "telephone_number": "847-731-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOUDEH",
        "first_name": "MOHANAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-23",
        "last_updated": "2015-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036127003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zion, IL

Sources for this page

Verify at the official NPI Registry.