Individual provider Active NPI

Ali Hussain, DO

  • Family Medicine Physician
  • Palatine, IL
National Provider Identifier
1669728598
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OT014823 Issued in PA
Practice address
453 S Vermont St Ste C
Palatine, IL 60067-6968
Phone
(133) 596-0019
Fax
(913) 359-5552
NPI assigned
Jul 30, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OT014823 PA Primary

Addresses

Primary practice location

453 S Vermont St Ste C
Palatine, IL 60067-6968

Mailing address

601 E Main St Ste 101
Mahomet, IL 61853-7460
Phone (913) 359-6001

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
I20221229001228 IL Practitioner - Family Practice 8820372212 Practice locations: Aurora, IL

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OT014823PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MBS Envision LLC CurrentSince Dec 18, 2022 Accepting new patients
Patheous Medical PLLC CurrentSince Dec 20, 2023 Accepting new patients

Locations

601 E Main St
Ste 101
Mahomet, IL 61853
Phone (913) 359-6001

453 S Vermont St
Ste C
Palatine, IL 60067
Phone (913) 359-6001

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.

NPI Registry JSON

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

{
    "created_epoch": "1343606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1669728598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 E MAIN ST STE 101",
            "city": "MAHOMET",
            "state": "IL",
            "postal_code": "618537460",
            "telephone_number": "913-359-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "453 S VERMONT ST STE C",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600676968",
            "telephone_number": "133-596-0019",
            "fax_number": "913-359-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSSAIN",
        "first_name": "ALI",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-30",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OT014823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palatine, IL

Sources for this page

Verify at the official NPI Registry.