NPIMap

Organization Active NPI

Mediverse Professional Group PLLC

  • Multi-Specialty Clinic/Center
  • Oak Brook, IL
National Provider Identifier
1902695497
Registry record updated Oct 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
MEDIVERSE PROFESSIONAL GROUP PLLC
Practice address
2210 Midwest Rd Ste 111
Oak Brook, IL 60523-8206
Phone
(888) 632-1240
NPI assigned
May 2, 2025
Last updated
Oct 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2026

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

Authorized official

Name
Usman Kareem Qadeer, MDNPI 1467728378
Title
President
Phone
(574) 800-1646

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X NU
Psychiatry Physician 2084P0800X NU
Vascular Neurology Physician 2084V0102X NU
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

2210 Midwest Rd Ste 111
Oak Brook, IL 60523-8206

Mailing address

2210 Midwest Rd Ste 111
Oak Brook, IL 60523-8206
Phone (888) 632-1240

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250903000691 IL Part B Supplier - Clinic/Group Practice 9335640085 Receives reassigned benefits from 4 practitioners
Practice locations: Oak Brook, IL

National Provider Directory

National Provider Directory
Tax ID family
Mediverse Professional Group PLLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1S131 Summit Ave
Oakbrook Terrace, IL 60181

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1746144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790899200000",
    "number": "1902695497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 MIDWEST RD STE 111",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238206",
            "telephone_number": "888-632-1240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 MIDWEST RD STE 111",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238206",
            "telephone_number": "888-632-1240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIVERSE PROFESSIONAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-02",
        "last_updated": "2026-10-02",
        "certification_date": "2026-10-02",
        "status": "A",
        "authorized_official_last_name": "QADEER",
        "authorized_official_first_name": "USMAN",
        "authorized_official_middle_name": "KAREEM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "574-800-1646",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Brook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2026; 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.