Individual provider Active NPI

Abdol Hosseinian, MD

  • Obstetrics & Gynecology Physician
  • Chicago, IL
National Provider Identifier
1811978448
Registry record updated Oct 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036044385 Issued in IL
Practice address
2800 N Sheridan Rd
Suite 304
Chicago, IL 60657-6156
Phone
(773) 525-4500
Fax
(773) 525-3416
NPI assigned
Nov 10, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036044385 IL Primary

Addresses

Primary practice location

2800 N Sheridan Rd
Suite 304
Chicago, IL 60657-6156

Mailing address

4250 N Marine Dr
Suite 236
Chicago, IL 60613-1744
Phone (773) 404-0160

Other identifiers 1

IdentifierTypeStateIssuer
036044385MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036044385ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Abdol Hosseinian MD Obstetrics & Gynecology PastSince Sep 1, 1993 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254700800000",
    "number": "1811978448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4250 N MARINE DR",
            "address_2": "SUITE 236",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606131744",
            "telephone_number": "773-404-0160",
            "fax_number": "773-404-9876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 N SHERIDAN RD",
            "address_2": "SUITE 304",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606576156",
            "telephone_number": "773-525-4500",
            "fax_number": "773-525-3416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOSSEINIAN",
        "first_name": "ABDOL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2009-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036044385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036044385",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.