Individual provider Active NPI

Syeda A. Iftikhar, M.D.

  • Internal Medicine Physician
  • Libertyville, IL
National Provider Identifier
1770599938
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036102332 Issued in IL
Practice address
1507 S Falcon Dr
Libertyville, IL 60048-4897
Phone
(224) 567-8713
Fax
(224) 444-4533
NPI assigned
Jul 31, 2006
Last updated
Nov 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 18039 ND
Internal Medicine Physician 207R00000X 21284 NE
Internal Medicine Physician 207R00000X 036102332 IL Primary

Addresses

Primary practice location

1507 S Falcon Dr
Libertyville, IL 60048-4897

Mailing address

1507 S Falcon Dr
Libertyville, IL 60048-4897
Phone (224) 475-9496

Other identifiers 5

IdentifierTypeStateIssuer
036102332MedicaidIL
35503OtherNEBLUE CROSS BLUE SHIELD
K51298OtherILMEDICARE PTAN
110232141OtherNERAILROAD MEDICARE
DN4121OtherILRAILROAD MEDICARE

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
I20080111000724 IL Practitioner - Internal MedicinePractitioner - Infectious Disease 4385652387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Infectious Disease
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1507 S Falcon Dr
Libertyville, IL 60048-4897
Phone (847) 494-0265

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18039NDMDInternal Medicine Physician
21284NEMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medicine of Illinois SC Internal Medicine CurrentSince Feb 1, 2008 Accepting new patients
Annie Jeffrey Memorial County Health Center Internal Medicine Past Accepting new patients
Annie Jeffrey Memorial County Health Center Past Accepting new patients
Annie Jeffrey Memorial County Health Center Past Accepting new patients
Excellent Health Care Services, Inc. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/anniej-86ce9832

Organizations & group practices 5

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 1

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1770599938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 S FALCON DR",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600484897",
            "telephone_number": "224-475-9496",
            "fax_number": "224-444-4533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 S FALCON DR",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600484897",
            "telephone_number": "224-567-8713",
            "fax_number": "224-444-4533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IFTIKHAR",
        "first_name": "SYEDA",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ND",
            "license": "18039",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "21284",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036102332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036102332",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "35503",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "K51298",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110232141",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DN4121",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

Verify at the official NPI Registry.