NPIMap

Individual provider Active NPI

Farooq Mohammed Hussain, MD

  • Family Medicine Physician
  • New Lenox, IL
National Provider Identifier
1942509369
Registry record updated Aug 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036.133698 Issued in IL
Practice address
1890 Silver Cross Blvd
Suite 370
New Lenox, IL 60451-9524
Phone
(815) 300-1450
NPI assigned
Mar 24, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036.133698 IL Primary

Addresses

Primary practice location

1890 Silver Cross Blvd
Suite 370
New Lenox, IL 60451-9524

Mailing address

1890 Silver Cross Blvd
Suite 370
New Lenox, IL 60451-9524
Phone (815) 300-1450

Other names 1

  • Tajammul Hussain Farooq Mohammed Former name

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
I20141222001895 IL Practitioner - Family Practice 2466775580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Service Systems, IncGroup PAC ID 2264408699, 63 clinicians

Practice addresses (Care Compare)

1890 Silver Cross Blvd
Suite 265
New Lenox, IL 60451-9623
Phone (815) 727-4292

1900 Silver Cross Blvd
New Lenox, IL 60451-9509

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.133698ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health Service Systems, Inc Family Medicine CurrentSince Sep 1, 2016 Accepting new patients
Health Service Systems, Inc CurrentSince Sep 1, 2016 Accepting new patients

Locations

1900 Silver Cross Blvd
New Lenox, IL 60451
Phone (815) 300-7106

1890 Silver Cross Blvd
Ste 265
New Lenox, IL 60451
Phone (815) 727-4292

1890 Silver Cross Blvd
Ste 370
New Lenox, IL 60451
Phone (815) 300-1450

Organizations & group practices 2

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 7

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": "1300924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470873600000",
    "number": "1942509369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 SILVER CROSS BLVD",
            "address_2": "SUITE 370",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604519524",
            "telephone_number": "815-300-1450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 SILVER CROSS BLVD",
            "address_2": "SUITE 370",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604519524",
            "telephone_number": "815-300-1450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSSAIN",
        "first_name": "FAROOQ",
        "middle_name": "MOHAMMED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-24",
        "last_updated": "2016-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.133698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAJAMMUL",
            "last_name": "MOHAMMED",
            "middle_name": "HUSSAIN FAROOQ",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Lenox, IL

Sources for this page

Verify at the official NPI Registry.