NPIMap

Individual provider Active NPI

Kamran Ayub, MD

  • Gastroenterology Physician
  • Oak Lawn, IL
National Provider Identifier
1942317243
Registry record updated Jan 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036119910 Issued in IL
Practice address
9921 Southwest Hwy
Oak Lawn, IL 60453
Phone
(708) 499-5678
Fax
(708) 499-5685
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 036119910 IL Primary

Addresses

Primary practice location

9921 Southwest Hwy
Oak Lawn, IL 60453

Mailing address

9921 Southwest Highway
Oak Lawn, IL 60453
Phone (708) 499-5678

Other identifiers 9

IdentifierTypeStateIssuer
0039580OtherWALABOR & INDUSTRY
CI2250OtherILRRM GROUP PTAN
036119910MedicaidIL
P00126611OtherRAILROAD MEDICARE
P00609731OtherILRRM GROUP
8291247MedicaidWA
US7184341OtherWAAETNA/USHC SPECIALIST
1622260OtherILBCBS IL
7473AYOtherWABLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080313000466 IL Practitioner - Gastroenterology 6305824723 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gi Partners of Illinois PLLCGroup PAC ID 2567758295, 38 clinicians
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

1880 W Winchester Rd
Suite 201
Libertyville, IL 60048-5336
Phone (630) 952-1400

611 W Park St
Urbana, IL 61801-2500

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy263
Upper gastrointestinal (GI) endoscopy for acid reflux1531

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036119910ILMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carle Health Care Incorporated Gastroenterology CurrentSince Jun 4, 2020 Accepting new patients
New Lenox Anesthesia LLC Current Accepting new patients
Gi Partners of Illinois, PLLC Gastroenterology CurrentSince Nov 1, 2016 Accepting new patients
Carle Health Care Incorporated Past Accepting new patients
Southwest Center for Gastroenterology Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

3310 Fields South Dr
Champaign, IL 61822
Phone (217) 417-2352

4007 W 63rd St
Chicago, IL 60629
Phone (773) 767-2266

3815 Highland Ave
Downers Grove, IL 60515
Phone (630) 275-5900

1880 W Winchester Rd
Ste 201
Libertyville, IL 60048
Phone (847) 247-0187

678 Cedar Crossings Dr
New Lenox, IL 60451
Phone (708) 499-5678

9921 Southwest Hwy
Oak Lawn, IL 60453
Phone (708) 425-2552

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Organizations & group practices 6

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.

Hospital & facility affiliations 9

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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233014400000",
    "number": "1942317243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9921 SOUTHWEST HIGHWAY",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "60453",
            "telephone_number": "708-499-5678",
            "fax_number": "708-499-5685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9921 SOUTHWEST HWY",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "60453",
            "telephone_number": "708-499-5678",
            "fax_number": "708-499-5685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYUB",
        "first_name": "KAMRAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2009-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036119910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRY",
            "identifier": "0039580",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRM GROUP PTAN",
            "identifier": "CI2250",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036119910",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00126611",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRM GROUP",
            "identifier": "P00609731",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8291247",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA/USHC SPECIALIST",
            "identifier": "US7184341",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IL",
            "identifier": "1622260",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "7473AY",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

Verify at the official NPI Registry.