Organization Active NPI

Satyendra Kumar Humad MD SC

  • Rheumatology Physician
  • Evanston, IL
National Provider Identifier
1902167398
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
036064710 Issued in IL
Legal business name
SATYENDRA KUMAR HUMAD MD SC
Practice address
800 Austin St
Suite 208
Evanston, IL 60202-3439
Phone
(847) 866-8988
Fax
(847) 866-8990
NPI assigned
Jun 2, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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

Authorized official

Name
Dr. Satyendra Kumar Humad, MDNPI 1457460156
Title
Owner
Phone
(847) 866-8988

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RR0500X 036064710 IL Primary

Addresses

Primary practice location

800 Austin St
Suite 208
Evanston, IL 60202-3439

Mailing address

800 Austin St
Suite 208
Evanston, IL 60202-3439
Phone (847) 866-8988

Other identifiers 1

IdentifierTypeStateIssuer
036064710MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121001000068 IL Part B Supplier - Clinic/Group Practice 2668621012 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL; Evanston, IL

National Provider Directory

National Provider Directory

Locations

2740 W Foster Ave
Ste 111
Chicago, IL 60625
Phone (773) 769-9040

800 Austin St
Ste 208
Evanston, IL 60202
Phone (847) 866-8988

800 Austin St
Ste 208W
Evanston, IL 60202
Phone (847) 866-8988

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1338595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348704000000",
    "number": "1902167398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 AUSTIN ST",
            "address_2": "SUITE 208",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602023439",
            "telephone_number": "847-866-8988",
            "fax_number": "847-866-8990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 AUSTIN ST",
            "address_2": "SUITE 208",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602023439",
            "telephone_number": "847-866-8988",
            "fax_number": "847-866-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SATYENDRA KUMAR HUMAD MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-02",
        "last_updated": "2012-09-27",
        "status": "A",
        "authorized_official_last_name": "HUMAD",
        "authorized_official_first_name": "SATYENDRA",
        "authorized_official_middle_name": "KUMAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-866-8988",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "IL",
            "license": "036064710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036064710",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.