Individual provider Active NPI

Tariq Ahmed, DC

  • Chiropractor
  • Roselle, IL
National Provider Identifier
1750448320
Registry record updated Jul 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-008665 Issued in IL
Practice address
50 Irving Park Rd
Roselle, IL 60172
Phone
(630) 295-8851
Fax
(630) 295-8852
NPI assigned
Jan 3, 2007
Last updated
Jul 28, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038-008665 IL Primary

Addresses

Primary practice location

50 Irving Park Rd
Roselle, IL 60172

Mailing address

50 Irving Park Rd
Roselle, IL 60172
Phone (630) 295-8851

Other identifiers 2

IdentifierTypeStateIssuer
038008665MedicaidIL
2232174OtherILBCBS OF IL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050802000247 IL Practitioner - Chiropractic 4981632981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National University of Arts and Sciences, Medical Department, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

50 E Irving Park Rd
Roselle, IL 60172-2050
Phone (630) 295-8851

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-008665ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Physical Medicine Group SC Chiropractor Current Accepting new patients
Roselle Chiropractic Inc Chiropractor CurrentSince Oct 15, 2002 Accepting new patients

Locations

17W697 Butterfield Rd
Oakbrook Terrace, IL 60181
Phone (630) 351-0775

17W697 Butterfield Rd
Ste B
Oakbrook Terrace, IL 60181
Phone (630) 620-8322

50 E Irving Park Rd
Roselle, IL 60172
Phone (630) 295-8851

630 N Addison Rd
Villa Park, IL 60181
Phone (630) 279-7703

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469664000000",
    "number": "1750448320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 IRVING PARK RD",
            "city": "ROSELLE",
            "state": "IL",
            "postal_code": "60172",
            "telephone_number": "630-295-8851",
            "fax_number": "630-295-8852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 IRVING PARK RD",
            "city": "ROSELLE",
            "state": "IL",
            "postal_code": "60172",
            "telephone_number": "630-295-8851",
            "fax_number": "630-295-8852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "TARIQ",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2016-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-008665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038008665",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL",
            "identifier": "2232174",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roselle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.