Individual provider Active NPI

Nadia Momin, MD

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1750692216
Registry record updated May 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD042524 Issued in DC
Practice address
800 E 55TH St
Chicago, IL 60615
Phone
(773) 702-0660
NPI assigned
Jun 29, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036133642 IL
Family Medicine Physician 207Q00000X MD042524 DC Primary

Addresses

Primary practice location

800 E 55TH St
Chicago, IL 60615

Mailing address

800 E 55TH St
Chicago, IL 60615-4906
Phone (773) 702-0660

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
I20170118002165 IL Practitioner - Family Practice 8325356041 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Primary Care Associates LTDGroup PAC ID 7416917059, 9 clinicians

Practice addresses (Care Compare)

6840 W Windsor Ave
Berwyn, IL 60402-3441
Phone (708) 484-0042

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Macneal Hospital Hospital, Berwyn, IL, CCN 140054
  • Loyola University Medical Center Hospital, Maywood, IL, CCN 140276
  • Uchicago Medicine Adventhealth Hinsdale Hospital, Hinsdale, IL, CCN 140122

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD042524DCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Associates LTD Family Medicine CurrentSince Jun 1, 2019 Accepting new patients
Friend Family Health Center Inc CurrentSince Dec 12, 2016 Accepting new patients
Friend Family Health Center Inc Current Accepting new patients

Locations

6840 W Windsor Ave
Berwyn, IL 60402
Phone (708) 484-0042

1522 E 63rd St
Chicago, IL 60637
Phone (773) 795-2260

800 E 55th St
Chicago, IL 60615
Phone (773) 702-2193

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 7

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": "1277769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527638400000",
    "number": "1750692216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E 55TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154906",
            "telephone_number": "773-702-0660",
            "fax_number": "773-834-3756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E 55TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60615",
            "telephone_number": "773-702-0660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOMIN",
        "first_name": "NADIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-29",
        "last_updated": "2018-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036133642",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DC",
            "license": "MD042524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.