NPIMap

Organization Active NPI

Hampshire Clinic SC

  • Internal Medicine Physician
  • Hampshire, IL
National Provider Identifier
1740396225
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
HAMPSHIRE CLINIC SC
Practice address
153 S State St
Hampshire, IL 60140-7010
Phone
(847) 683-3661
NPI assigned
Aug 21, 2006
Last updated
Jun 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Authorized official

Name
Farzana S Hosain, MDNPI 1114031382
Title
Owner
Phone
(630) 995-6635

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

153 S State St
Hampshire, IL 60140-7010

Mailing address

153 S State St
Hampshire, IL 60140-7010
Phone (847) 683-3661

Other practice location 1

2971 W Algonquin Rd Ste 103
Algonquin, IL 60102-9407
Phone (847) 683-3661

Other names 1

  • HAMPSHIRE CLINIC INC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110126000103 IL Part B Supplier - Clinic/Group Practice 7214116003 Receives reassigned benefits from 1 practitioner
Practice locations: Hampshire, IL

National Provider Directory

National Provider Directory

Locations

153 S State St
Hampshire, IL 60140
Phone (708) 683-3661

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718236800000",
    "number": "1740396225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 S STATE ST",
            "city": "HAMPSHIRE",
            "state": "IL",
            "postal_code": "601407010",
            "telephone_number": "847-683-3661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 S STATE ST",
            "city": "HAMPSHIRE",
            "state": "IL",
            "postal_code": "601407010",
            "telephone_number": "847-683-3661"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2971 W Algonquin Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Algonquin",
            "state": "IL",
            "postal_code": "601029407",
            "country_code": "US",
            "telephone_number": "847-683-3661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HAMPSHIRE CLINIC SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A",
        "authorized_official_last_name": "HOSAIN",
        "authorized_official_first_name": "FARZANA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-995-6635",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HAMPSHIRE CLINIC INC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hampshire, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.