Individual provider Active NPI

Ashraf Arman Uddin

  • Endocrinology, Diabetes & Metabolism Physician
  • Bourbonnais, IL
National Provider Identifier
1699262782
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
036165411 Issued in IL
Practice address
100 Fitness Dr
Bourbonnais, IL 60914-9584
Phone
(815) 936-8909
NPI assigned
Apr 16, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 036165411 IL Primary

Addresses

Primary practice location

100 Fitness Dr
Bourbonnais, IL 60914-9584

Mailing address

100 Fitness Dr
Bourbonnais, IL 60914-9584
Phone (815) 936-8909

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
I20230824002326 IL Practitioner - Endocrinology 3375946742 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Health SystemGroup PAC ID 3274434717, 202 clinicians

Practice addresses (Care Compare)

100 Fitness Dr
Bourbonnais, IL 60914-9584
Phone (815) 936-8909

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Health System CurrentSince Oct 1, 2023 Accepting new patients
Riverside Health System CurrentSince Oct 1, 2023 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

300 Riverside Dr
Ste 2100
Bourbonnais, IL 60914
Phone (815) 928-9666

100 Fitness Dr
Bourbonnais, IL 60914
Phone (815) 936-6515

105 S First St
Wilmington, IL 60481
Phone (815) 476-5210

Interoperability endpoints

  • Direct secure messaging: auddin45914@direct.riversidehealthcare.net

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 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": "1523836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1699262782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 FITNESS DR",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609149584",
            "telephone_number": "815-936-8909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 FITNESS DR",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609149584",
            "telephone_number": "815-936-8909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDDIN",
        "first_name": "ASHRAF",
        "middle_name": "ARMAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-16",
        "last_updated": "2023-09-28",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IL",
            "license": "036165411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bourbonnais, IL

Sources for this page

Verify at the official NPI Registry.