Idries Abdur-Rahman, M.D.
Individual provider Active NPI Obstetrics & Gynecology Physician · Ottawa, IL
NPI 1891727236 · NPPES record last updated Sep 5, 2012
Key facts
- NPI
- 1891727236
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 036114960 (IL)
- Practice address
- 1300 Starfire Dr
Suite B
Ottawa, IL 61350-1624 - Phone
- (815) 434-2229
- Fax
- (815) 434-4229
- NPI assigned
- Jul 7, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 10
Medicare Care Compare profile
- Specialty
- Obstetrics/Gynecology
- Education
- Rush Medical College of Rush University, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
4504 Estate Diamond
Suite 4
Christiansted, VI 00820-5233
Phone (340) 713-0330
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of the uterus | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in IL, VI, CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20061023000367 | IL | Practitioner - Obstetrics/Gynecology | 4688671332 | Reassigns benefits to 2 organizations |
| I20240223002043 | VI | Practitioner - Obstetrics/Gynecology | 4688671332 | Reassigns benefits to 2 organizations |
| I20251217002533 | CA | Practitioner - Obstetrics/Gynecology | 4688671332 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Lake | Current | Accepting new patients | |
| The Womens Wellness Group, Professional LLC | Obstetrics & Gynecology | Current |
Accepting new patients |
| Governor Juan F. Luis Hospital & Medical Center | Current |
Accepting new patients | |
| Adventist Health Physicians Network | Current |
Accepting new patients | |
| Governor Juan F. Luis Hospital & Medical Center | Current |
Accepting new patients | |
| County of Lake | Current |
Accepting new patients | |
| County of Lake | Current |
Accepting new patients | |
| Adventist Health Physicians Network | Current |
Accepting new patients |
Locations
1154 E Grand Ave
Arroyo Grande, CA 93420
Phone (805) 395-3277
3 S Greenleaf St
Ste A
Gurnee, IL 60031
Phone (847) 244-0222
890 Garfield Ave
Ste 203
Libertyville, IL 60048
Phone (224) 433-6239
2400 Belvidere Rd
Waukegan, IL 60085
Phone (847) 377-8400
3010 Grand Ave
Waukegan, IL 60085
Phone (847) 377-8296
4504 Estate Diamond
Ste 4
Christiansted, VI 00820
Phone (340) 713-0330
4007 Estate Diamond Ruby
St Croix, VI 00820
Phone (340) 772-7423
Interoperability endpoints
- idries.abdur-rahman.1@20105.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 036114960 | IL | Yes |
Addresses
Primary practice location
1300 Starfire Dr
Suite B
Ottawa, IL 61350-1624
Mailing address
1300 Starfire Dr
Suite B
Ottawa, IL 61350-1624
Phone (815) 434-2229
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- Accelerated Rehabilitation Centers, LTD
- Shahamah Ahmed
- Kimberly Sharon Alamprese
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All providers in Ottawa, IL · Obstetrics & Gynecology Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 5, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.