NPIMap

Individual provider Active NPI

Ahmed Nazimuddin, M.D.

  • Internal Medicine Physician
  • Burr Ridge, IL
National Provider Identifier
1710140975
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036128135 Issued in IL
Practice address
6101 S County Line Rd
Burr Ridge, IL 60527-8132
Phone
(630) 686-9000
Fax
(844) 235-2578
NPI assigned
Jul 8, 2008
Last updated
Aug 25, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 125054244 IL
Internal Medicine Physician 207R00000X 036128135 IL Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 036128135 IL

Addresses

Primary practice location

6101 S County Line Rd
Burr Ridge, IL 60527-8132

Mailing address

1860 Paysphere Cir
Chicago, IL 60674-8132
Phone (630) 469-9200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ahmed.nazimuddin@dulyhealthandcare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120809000610 IL Practitioner - Geriatric Medicine 3971759739 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Geriatric Medicine
Education
Rush Medical College of Rush University, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Home Physicians LLCGroup PAC ID 4981988771, 81 clinicians

Practice addresses (Care Compare)

1 S450 Summit Ave
Suite 165
Oakbrook Terrace, IL 60181-3952
Phone (630) 320-6871

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036128135ILMDInternal Medicine Physician
125054244ILMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Community Home Physicians, LLC Internal Medicine CurrentSince Jan 7, 2023 Accepting new patients
Elmhurst Memorial Healthcare Past Accepting new patients

Locations

2015 S Arlington Heights Rd
Arlington Heights, IL 60005
Phone (847) 258-4978

1S450 Summit Ave
Ste 165
Oakbrook Terrace, IL 60181
Phone (630) 320-6871

Interoperability endpoints

  • Direct secure messaging: ahmed.nazimuddin@dulyhealthandcare.com
  • Direct secure messaging: ms_anazimud@landmarkhealth-direct.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1710140975",
    "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": "606748132",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 S COUNTY LINE RD",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605278132",
            "telephone_number": "630-686-9000",
            "fax_number": "844-235-2578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAZIMUDDIN",
        "first_name": "AHMED",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-08",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "125054244",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036128135",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "036128135",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ahmed.nazimuddin@dulyhealthandcare.com",
            "affiliation": "N",
            "address_1": "6101 S County Line Rd",
            "city": "Burr Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605278132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Burr Ridge, IL

Sources for this page

Verify at the official NPI Registry.