Rustam Safarov, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209.019746 Issued in IL

Practice address

10 N Milwaukee Ave
Wheeling, IL 60090-3012

Phone

(800) 323-8622

NPI assigned

Apr 28, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Stat Cardiologist IncGroup PAC ID 1658648050, 27 clinicians

Advocate Health and Hospitals CorporationGroup PAC ID 7810800935, 3,081 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Advocate Health and Hospitals Corporation

  • Multi-Specialty Clinic/Center
  • Oak Brook, IL
  • NPI 1700824455

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Stat Cardiologist Inc

  • Cardiovascular Disease Physician
  • Schaumburg, IL
  • NPI 1528596350

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Advocate Health and Hospitals Corporation

  • Children's Hospital
  • Oak Lawn, IL
  • NPI 1508315516
  NPD
• Advanced Family Clinic LTD

  • General Practice Physician
  • Chicago, IL
  • NPI 1093977175

  Single Specialty

  NPD (past)
• Stat Medical Practices Inc

  • Internal Medicine Physician
  • Schaumburg, IL
  • NPI 1174490023

  Nurse Practitioner

  NPD (past)

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

{
    "created_epoch": "1556409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1770147480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900",
            "fax_number": "847-390-4757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 N MILWAUKEE AVE",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600903012",
            "telephone_number": "800-323-8622"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 E Phillip Rd",
            "address_purpose": "LOCATION",
            "city": "Vernon Hills",
            "state": "IL",
            "postal_code": "600611700",
            "country_code": "US",
            "telephone_number": "847-680-0500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAFAROV",
        "first_name": "RUSTAM",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-28",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "F03190845",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.019746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rsafarov237400@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "10 N Milwaukee Ave",
            "city": "Wheeling",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600903012",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "10 N Milwaukee Ave",
            "city": "Wheeling",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600903012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Yakov Ryabov, MD
• Vicky P Ryan
• Violetta Rychcik, PTA
• Sacred Spaces, Inc
• Lauren Michelle Saetre, ED.S., NCSP
• Clive A Salvacion, PT
• Sam'S Club Optical
• San Fernando Healthcare Inc
• Monica Deleo Santilli, MS CCC-SLP
• Megan Santoro, BS

• Nurse Practitioner in Wheeling, IL
• Providers in Wheeling, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.